卡拉奇三级医院新冠肺炎阳性患者细菌共感染频率分析

F. Khan, A. Fatima, Hareem Gohar, Mehwish Sajjad, M. Siddiqui, Saima Naseem
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摘要

目的:了解新型冠状病毒感染阳性患者细菌合并感染的频率。方法:一项前瞻性横断面研究于2021年11月15日至2022年4月15日在巴基斯坦微生物学系进行。采集血液和呼吸道样本,包括痰液、支气管灌洗液和气管吸入物。临床标本接种于羊血琼脂板、巧克力琼脂板(需氧5% CO2)和麦康基琼脂上。鉴定之后是具体和标准的微生物方案。经定性PCR证实为新型冠状病毒。采用Kirby Bauer纸片扩散法进行药敏试验。结果:采集新冠肺炎阳性患者血液、痰液、气管吸入物、支气管灌洗液等临床标本202份。男性患者多见于痰液和气管吸入物,女性患者多见于血培养物。大多数患者年龄在60岁以上。鲍曼不动杆菌主要从血液和气管吸入物中分离出来,表现出多药耐药,但对粘菌素完全敏感。肺炎克雷伯菌在痰液中患病率高,头孢菌素和复方新诺明完全耐药。结论:本研究得出了鲍曼不动杆菌、肺炎克雷伯菌和铜绿假单胞菌引起的高频率叠加细菌共感染。其中大多数是耐多药病原体,因此,需要采取紧急行动,控制耐药菌株引起的医院感染的传播,这是造成COVID-19危重患者死亡率高的原因。
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Frequency Of Bacterial Co-Infections Isolated from Covid-19 Positive Patients From Tertiary Care Hospital Of Karachi
Objective: This study aims to determine the frequency of bacterial co-infections in COVID-19-positive patients. Methodology: A prospective cross-sectional study was conducted in the Department of Microbiology, Pakistan, from November 15, 2021, to April 15, 2022. Blood and respiratory tract samples were collected, including sputum, bronchial lavage, and tracheal aspirate. Clinical specimens were inoculated onto a Sheep blood agar plate, Chocolate agar plate (aerobic with 5% CO2), and MacConkey’s agar. Identification was followed by specific and standard microbiological protocols. COVID-19 was confirmed by qualitative PCR. Antimicrobial susceptibility testing was performed using the Kirby Bauer disc diffusion method. Results: A total of 202 clinical samples, including blood, sputum, tracheal aspirates, and bronchial lavage, were collected from COVID-19-positive patients. Male patients were more common in sputum and tracheal aspirates, while female patients were more common in blood cultures. The majority of patients were over 60 years of age. Acinetobacter baumannii was predominantly isolated from blood and tracheal aspirates, exhibiting multidrug resistance, but showing complete sensitivity towards Colistin. Klebsiella pneumonia exhibited high prevalence in sputum, with complete resistance observed in Cephalosporins and Co-trimoxazole. Conclusion: The study concludes a high frequency of superadded bacterial co-infections, caused most prominently by Acinetobacter baumannii, Klebsiella pneumonia, and Pseudomonas aeruginosa. The majority of these are multidrug-resistant pathogens, therefore, urgent action is required to control the spread of nosocomial infections by resistant strains, which are responsible for the high mortality rate among COVID-19 critical patients.
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