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首页> 外文期刊>Journal of Medical Microbiology: An Official Journal of the Pathological Society of Great Britain and Ireland >Co-infection in critically ill patients with COVID-19: an observational cohort study from England
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Co-infection in critically ill patients with COVID-19: an observational cohort study from England

机译：Covid-19批评患者的共同感染：英格兰的观察队列研究

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Introduction During previous viral pandemics, reported co-infection rates and implicated pathogens have varied. In the 1918 influenza pandemic, a large proportion of severe illness and death was complicated by bacterial co-infection, predominantly Streptococcus pneumoniae and Staphylococcus aureus . Gap statement A better understanding of the incidence of co-infection in patients with COVID-19 infection and the pathogens involved is necessary for effective antimicrobial stewardship. Aim To describe the incidence and nature of co-infection in critically ill adults with COVID-19 infection in England. Methodology A retrospective cohort study of adults with COVID-19 admitted to seven intensive care units (ICUs) in England up to 18 May 2020, was performed. Patients with completed ICU stays were included. The proportion and type of organisms were determined at &48?and &48?h following hospital admission, corresponding to community and hospital-acquired co-infections. Results Of 254 patients studied (median age 59?years (IQR 49–69); 64.6?% male), 139 clinically significant organisms were identified from 83 (32.7?%) patients. Bacterial co-infections/ co-colonisation were identified within 48?h of admission in 14 (5.5?%) patients; the commonest pathogens were Staphylococcus aureus (four patients) and Streptococcus pneumoniae (two patients). The proportion of pathogens detected increased with duration of ICU stay, consisting largely of Gram-negative bacteria, particularly Klebsiella pneumoniae and Escherichia coli . The co-infection/ co-colonisation rate &48?h after admission was 27/1000 person-days (95?%?CI 21.3–34.1). Patients with co-infections/ co-colonisation were more likely to die in ICU (crude OR 1.78,95?%?CI 1.03–3.08, P =0.04) compared to those without co-infections/ co-colonisation. Conclusion We found limited evidence for community-acquired bacterial co-infection in hospitalised adults with COVID-19, but a high rate of Gram-negative infection acquired during ICU stay.
机译：在先前的病毒性大疱中引入，报告了共感染率和含有含有的病原体。在1918年的流感大流行中，细菌共感染的严重疾病和死亡的大部分复杂，主要是链球菌和金黄色葡萄球菌。 GAP陈述更好地了解Covid-19感染患者的共同感染发病率和所涉及的病原体是有效抗微生物管理所必需的。目的描述英格兰Covid-19感染批评性成年人的共同感染的发病率和性质。方法研究了Covid-19的成年人的回顾性队列研究，进入七个重症监护单位（ICU），在2020年5月18日，英格兰达到7月18日。完成了ICU住宿的患者。在＆amp; 48℃下测定生物的比例和类型。结果254名患者研究（中位数59岁？年（IQR 49-69）; 64.6？％男性），鉴定了139名临床显着的生物，从83例（32.7％）患者中鉴定出来。在14名（5.5μl）患者的入院48℃内鉴定了细菌的共染料;最常见的病原体是金黄色葡萄球菌（四名患者）和肺炎链球菌（两名患者）。检测到病原体的比例随着ICU停留的持续时间而增加，主要是革兰氏阴性细菌，特别是Klebsiella Pneumoniae和大肠杆菌。共感染/共殖度率＆amp; 入院后48？h为27/1000人 - 天（95？％？CI 21.3-34.1）。与那些没有共感化/共殖定相比，具有共感染/共置的患者在ICU（粗rude或1.78,95〜08，p = 0.04）中，更可能死亡。结论我们对住院成人的社区收购的细菌联合感染有限的证据是Covid-19，但在ICU住宿期间获得的高革兰阴性感染率高。

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