| Author | Costa, Rafael Lessa da | |
| Author | Lamas, Cristiane da Cruz | |
| Author | Simvoulidis, Luiz Fernando Nogueira | |
| Author | Espanha, Claudia Adelino | |
| Author | Moreira, Lorena Pinto Monteiro | |
| Author | Bonancim, Renan Alexandre Baptista | |
| Author | Weber, João Victor Lehmkuhl Azeredo | |
| Author | Ramos, Max Rogerio Freitas | |
| Author | Silva, Eduardo Costa de Freitas | |
| Author | Oliveira, Liszt Palmeira de | |
| Access date | 2022-05-16T13:48:13Z | |
| Available date | 2022-05-16T13:48:13Z | |
| Document date | 2022 | |
| Citation | COSTA, Rafael Lessa et al. Secondary infections in a cohort of patients with COVID-19 admitted to an intensive care unit: impact of gram-negative bacterial resistance. Revista do Instituto de Medicina Tropical de São Paulo, v. 64, n. 6, p. 1-10, Feb. 2022. | pt_BR |
| ISSN | 1678-9946 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/52690 | |
| Language | eng | pt_BR |
| Publisher | Scielo | pt_BR |
| Rights | open access | pt_BR |
| Title | Secondary infections in a cohort of patients with COVID-19 admitted to an intensive care unit: impact of gram-negative bacterial resistance | pt_BR |
| Type | Article | pt_BR |
| DOI | 10.1590/S1678-9946202264006 | |
| Abstract | Some studies have shown that secondary infections during the COVID-19 pandemic may have contributed to the high mortality. Our objective was to identify the frequency, types and etiology of bacterial infections in patients with COVID-19 admitted to an intensive care unit (ICU) and to evaluate the results of ICU stay, duration of mechanical ventilation (MV) and in-hospital mortality. It was a single-center study with a retrospective cohort of patients admitted consecutively to the ICU for more than 48 h between March and May 2020. Comparisons of groups with and without ICU- acquired infection were performed. A total of 191 patients with laboratory-confirmed COVID-19 were included and 57 patients had 97 secondary infectious events. The most frequent agents were Acinetobacter baumannii (28.9%), Pseudomonas aeruginosa (22.7%) and Klebsiella pneumoniae (14.4%); multi-drug resistance was present in 96% of A. baumannii and in 57% of K. pneumoniae. The most prevalent infection was ventilator-associated pneumonia in 57.9% of patients with bacterial infections, or 17.3% of all COVID-19 patients admitted to the ICU, followed by tracheobronchitis (26.3%). Patients with secondary infections had a longer ICU stay (40.0 vs. 17 days; p < 0.001), as well as a longer duration of MV (24.0 vs 9.0 days; p= 0.003). There were 68 (35.6%) deaths overall, of which 27 (39.7%) patients had bacterial infections. Among the 123 survivors, 30 (24.4%) had a secondary infections (OR 2.041; 95% CI 1.080 - 3.859). A high incidence of secondary infections, mainly caused by gram-negative bacteria has been observed. Secondary infections were associated with longer ICU stay, MV use and higher mortality. | pt_BR |
| Affilliation | Hospital Unimed-Rio. Unidade de Terapia Intensiva. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Instituto Nacional de Cardiologia. Rio de Janeiro, RJ, Brasil / Universidade Unigranrio. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Hospital Unimed-Rio. Unidade de Terapia Intensiva. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Hospital Unimed-Rio. Unidade de Terapia Intensiva. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Hospital Unimed-Rio. Unidade de Terapia Intensiva. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Hospital Unimed-Rio. Unidade de Terapia Intensiva. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Instituto Unimed-Rio. Unidade de Terapia Intensiva. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Instituto Unimed-Rio. Unidade de Terapia Intensiva. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Instituto Unimed-Rio. Unidade de Terapia Intensiva. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Instituto Unimed-Rio. Unidade de Terapia Intensiva. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Subject | COVID-19 | pt_BR |
| Subject | Secondary infections | pt_BR |
| Subject | Healthcare associated infection | pt_BR |
| Subject | Intensive care unit | pt_BR |
| Subject | Gram negatives | pt_BR |
| Subject | Multidrug-resistance | pt_BR |
| Subject | Ventilator-associated pneumonia | pt_BR |
| xmlui.metadata.dc.subject.ods | 03 Saúde e Bem-Estar | |
