{"title":"2019年印度第二波冠状病毒病中真菌和NDM-OXA产生革兰氏阴性细菌超级感染的高发率:来自印度北部2019年冠状病毒病专门医院的经验","authors":"Omika Katoch, Neha Sharad, Parul Singh, Sharad Srivastav, Richa Aggrawal, Rajesh Malhotra, Purva Mathur","doi":"10.4103/jgid.jgid_238_21","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>During the second wave of coronavirus disease 2019 (COVID-19), superinfection caused by fungus and multidrug-resistant bacteria worsened the severity of illness in COVID-19 patients. Limited studies from India reported the antimicrobial resistance pattern of secondary infections. In this study, we aim to study the epidemiology of pathogens causing superinfections and genotyping of Gram-negative isolates in COVID-19 patients.</p><p><strong>Methods: </strong>This retrospective study was conducted at a dedicated COVID-19 center, India. The identification of bacteria/fungi was done by Vitek2<sup>®</sup> and matrix-assisted laser desorption/ionization-time of flight mass spectrometry system. Identification of beta-lactamase genes was done using thermal cycler. The diagnosis of mucormycosis was based on 10% potassium hydroxide direct microscopy. Statistical analyses were performed using STATA version 15.1 (StataCorp., College Station, TX, USA). For continuous variables, mean and standard deviation were computed. For comparing proportions of secondary infections across admission location and outcomes, the Chi-squared test of independence was used. To compare the mean and median between intensive care units and outcomes, an independent <i>t</i>-test and a Mann-Whitney test were used.</p><p><strong>Results: </strong>Of all the clinical samples, 45.4% of samples were cultured positive for secondary infections. <i>Acinetobacter baumannii</i> (35%) was the most common Gram-negative pathogen, while among Gram positive, it was <i>Enterococcus faecium</i> (40%). Among fungus, Candida spp. (61%) predominates followed by molds. Colistin and tigecycline proved effective against these pathogens. <i>bla<sub>NDM</sub></i> was the most prevalent gene followed by the <i>bla<sub>OX</sub></i> among the carbapenemase genes.</p><p><strong>Conclusions: </strong>The mortality rate among COVID-19 patients with secondary infection was significantly higher compared to the overall mortality rate in COVID-19 patients.</p>","PeriodicalId":51581,"journal":{"name":"Journal of Global Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f2/27/JGID-14-154.PMC9831212.pdf","citationCount":"0","resultStr":"{\"title\":\"High Prevalence of Fungal and NDM-OXA Producing Gram-Negative Bacterial Superinfections in the Second Wave of Coronavirus Disease 2019 in India: Experience from a Dedicated Coronavirus Disease 2019 Hospital in North India.\",\"authors\":\"Omika Katoch, Neha Sharad, Parul Singh, Sharad Srivastav, Richa Aggrawal, Rajesh Malhotra, Purva Mathur\",\"doi\":\"10.4103/jgid.jgid_238_21\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>During the second wave of coronavirus disease 2019 (COVID-19), superinfection caused by fungus and multidrug-resistant bacteria worsened the severity of illness in COVID-19 patients. Limited studies from India reported the antimicrobial resistance pattern of secondary infections. In this study, we aim to study the epidemiology of pathogens causing superinfections and genotyping of Gram-negative isolates in COVID-19 patients.</p><p><strong>Methods: </strong>This retrospective study was conducted at a dedicated COVID-19 center, India. The identification of bacteria/fungi was done by Vitek2<sup>®</sup> and matrix-assisted laser desorption/ionization-time of flight mass spectrometry system. Identification of beta-lactamase genes was done using thermal cycler. The diagnosis of mucormycosis was based on 10% potassium hydroxide direct microscopy. Statistical analyses were performed using STATA version 15.1 (StataCorp., College Station, TX, USA). For continuous variables, mean and standard deviation were computed. For comparing proportions of secondary infections across admission location and outcomes, the Chi-squared test of independence was used. To compare the mean and median between intensive care units and outcomes, an independent <i>t</i>-test and a Mann-Whitney test were used.</p><p><strong>Results: </strong>Of all the clinical samples, 45.4% of samples were cultured positive for secondary infections. <i>Acinetobacter baumannii</i> (35%) was the most common Gram-negative pathogen, while among Gram positive, it was <i>Enterococcus faecium</i> (40%). Among fungus, Candida spp. (61%) predominates followed by molds. Colistin and tigecycline proved effective against these pathogens. <i>bla<sub>NDM</sub></i> was the most prevalent gene followed by the <i>bla<sub>OX</sub></i> among the carbapenemase genes.</p><p><strong>Conclusions: </strong>The mortality rate among COVID-19 patients with secondary infection was significantly higher compared to the overall mortality rate in COVID-19 patients.</p>\",\"PeriodicalId\":51581,\"journal\":{\"name\":\"Journal of Global Infectious Diseases\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2022-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f2/27/JGID-14-154.PMC9831212.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Global Infectious Diseases\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/jgid.jgid_238_21\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Global Infectious Diseases","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/jgid.jgid_238_21","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
High Prevalence of Fungal and NDM-OXA Producing Gram-Negative Bacterial Superinfections in the Second Wave of Coronavirus Disease 2019 in India: Experience from a Dedicated Coronavirus Disease 2019 Hospital in North India.
Introduction: During the second wave of coronavirus disease 2019 (COVID-19), superinfection caused by fungus and multidrug-resistant bacteria worsened the severity of illness in COVID-19 patients. Limited studies from India reported the antimicrobial resistance pattern of secondary infections. In this study, we aim to study the epidemiology of pathogens causing superinfections and genotyping of Gram-negative isolates in COVID-19 patients.
Methods: This retrospective study was conducted at a dedicated COVID-19 center, India. The identification of bacteria/fungi was done by Vitek2® and matrix-assisted laser desorption/ionization-time of flight mass spectrometry system. Identification of beta-lactamase genes was done using thermal cycler. The diagnosis of mucormycosis was based on 10% potassium hydroxide direct microscopy. Statistical analyses were performed using STATA version 15.1 (StataCorp., College Station, TX, USA). For continuous variables, mean and standard deviation were computed. For comparing proportions of secondary infections across admission location and outcomes, the Chi-squared test of independence was used. To compare the mean and median between intensive care units and outcomes, an independent t-test and a Mann-Whitney test were used.
Results: Of all the clinical samples, 45.4% of samples were cultured positive for secondary infections. Acinetobacter baumannii (35%) was the most common Gram-negative pathogen, while among Gram positive, it was Enterococcus faecium (40%). Among fungus, Candida spp. (61%) predominates followed by molds. Colistin and tigecycline proved effective against these pathogens. blaNDM was the most prevalent gene followed by the blaOX among the carbapenemase genes.
Conclusions: The mortality rate among COVID-19 patients with secondary infection was significantly higher compared to the overall mortality rate in COVID-19 patients.
期刊介绍：
JGID encourages research, education and dissemination of knowledge in the field of Infectious Diseases across the world thus promoting translational research by striking a synergy between basic science, clinical medicine and public health. The Journal intends to bring together scientists and academicians in Infectious Diseases to promote translational synergy between Laboratory Science, Clinical Medicine and Public Health. The Journal invites Original Articles, Clinical Investigations, Epidemiological Analysis, Data Protocols, Case Reports, Clinical Photographs, review articles and special commentaries. Students, Residents, Academicians, Public Health experts and scientists are all encouraged to be a part of this initiative by contributing, reviewing and promoting scientific works and science.
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