The Prevalence of Early- and Late-Onset Bacterial, Viral and Fungal Respiratory Superinfections in Invasively Ventilated COVID-19 Patients

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J Med Virol. 2021 Dec 24. doi: 10.1002/jmv.27548. Online ahead of print.


The role of respiratory superinfections in patients with COVID-19 pneumonia remains unclear. We investigated the prevalence of early- and late onset superinfections in invasively ventilated patients with COVID-19 pneumonia, admitted to our department of intensive care medicine between March 2020 and November 2020. Of the 102 cases, 74 (72.5%) received invasive ventilation and were tested for viral, bacterial and fungal pathogens on day 0-7, 8-14 and 15-21 after the initiation of mechanical ventilation. Approximately 45% developed one or more respiratory superinfections. There was a clear correlation between the duration of invasive ventilation and the prevalence of co-infecting pathogens. Males, patients with obesity and those suffering from chronic obstructive pulmonary disease and/or diabetes mellitus had a significantly higher probability to develop a respiratory superinfection. The prevalence of viral co-infections was high, with a predominance of herpes simplex virus (HSV), followed by cytomegalovirus (CMV). No respiratory viruses or intracellular bacteria were detected in our cohort. We observed a high co-incidence between Aspergillus fumigatus and HSV infection. Gram-negative bacteria were the most frequent pathogen group. Klebsiella aerogenes was detected early after intubation, while Klebsiella pneumoniae and Pseudomonas aeruginosa were related to a prolonged respiratory weaning. This article is protected by copyright. All rights reserved.

PMID:34951498 | DOI:10.1002/jmv.27548