Tri Pudy Asmarawati, - and Alfian Nur Rosyid, - and Satriyo Dwi Suryantoro, - and Bagus Aulia Mahdi, - and Choirina Windradi, - and Prastuti Asta Wulaningrum, - and Muhammad Vitanata Arfijanto, - and Bramantono, - and Erwin Astha Triyono, - and Musofa Rusli, - and Brian Eka Rachman, - and Erika Marfiani, - and Pepy Dwi Endraswari, - and Usman Hadi, - and Kuntaman, - and Nasronudin, - (2021) The clinical impact of bacterial co-infection among moderate, severe and critically ill COVID-19 patients in the second referral hospital in Surabaya [version 2; peer review: 2 approved]. F1000Research, 10 (113). pp. 1-16. ISSN 20461402

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Abstract

Background: Data on the prevalence of bacterial co-infections among COVID-19 patients are limited, especially in our country, Indonesia. We aimed to assess the rate of bacterial co-infections in hospitalized COVID-19 patients and report the most common microorganisms involved and the antibiotic use in these patients. Methods: This study is a retrospective cohort study, among COVID-19 adult patients admitted to Universitas Airlangga Hospital Surabaya from 14 March-30 September 2020. The bacterial infection is defined based on clinical assessment, laboratory parameters, and microbiology results. Results: A total of 218 patients with moderate to critical illness and confirmed COVID-19 were included in this study. Bacterial infection was confirmed in 43 patients (19.7%). COVID-19 patients with bacterial infections had longer hospital length of stay (17.6 ± 6.62 vs 13.31±7.12), a higher proportion of respiratory failure, intensive care treatment, and ventilator use. COVID-19 patients with bacterial infection had a worse prognosis than those without bacterial infection (p<0.04). The empirical antibiotic was given to 75.2% of the patients. Gram-negative bacteria were commonly found as causative agents in this study (n = 39; 70.37%). Conclusion: COVID-19 patients with bacterial infection have a longer length of stay and worse outcomes. Healthcare-associated infections during intensive care treatment for COVID-19 patients must be carefully prevented.

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