HealthDay News — Bacterial and fungal infections are uncommon in hospitalized COVID-19 patients, but coinfection is associated with high mortality and antibiotic use is widespread, according to a study published in Infection Control & Hospital Epidemiology.

Priya Nori, MD, from the Albert Einstein College of Medicine in Bronx, New York, and colleagues conducted a retrospective observational study of COVID-19 patients admitted between March 1, 2020, and April 18, 2020, to characterize the microbiology of bacterial and fungal coinfections during the pandemic surge.

The researchers identified bacterial or fungal coinfections in 152 of 4267 COVID-19 patients (3.6%); mortality was 57%, while 16% of patients were discharged and 28% were still admitted at the time of analysis; 74% of patients received mechanical ventilation. Overall, 91 (60%), 82 (54%), and 21 (14%) patients had positive respiratory cultures, positive blood cultures, and both positive blood and respiratory cultures, respectively; 9% of patients (13 patients) had polymicrobial cultures. Seventy-nine % of patients had antibiotic exposure in the 30 days before positive microbiology; 98% of the study patients received antibiotics at any point during COVID-19 hospitalization; 107 patients (70%) received more than three antibiotic classes. Of 5853 COVID-19 patients admitted between March 1 and May 31, 2020, 71% received at least one antibiotic dose.

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“The pandemic has highlighted the need for close collaboration between stewardship and infection prevention programs to monitor for nosocomial infections, excess antibiotic use and multidrug resistance,” the authors write.

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