Characterization of Secondary Bacterial Infections and Antibiotic Use in Mechanically Ventilated Patients With COVID-19 Induced Acute Respiratory Distress Syndrome

Background: COVID-19 has a widely variable clinical syndrome that is difficult to distinguish from bacterial sepsis, leading to high rates of antibiotic use. Early studies indicate low rates of secondary bacterial infections (SBIs) but have included heterogeneous patient populations. Here, we catalo...

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Bibliographic Details
Published in:Journal of intensive care medicine 2021-10, Vol.36 (10), p.1167-1175
Main Authors: Risa, Erik, Roach, David, Budak, Jehan Z., Hebert, Christopher, Chan, Jeannie D., Mani, Nandita S., Bryson-Cahn, Chloe, Town, James, Johnson, Nicholas J.
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - adverse effects
Bacterial Infections
COVID-19
Humans
Original Research
Respiration, Artificial
Respiratory Distress Syndrome - chemically induced
Respiratory Distress Syndrome - therapy
Retrospective Studies
SARS-CoV-2
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Summary:Background: COVID-19 has a widely variable clinical syndrome that is difficult to distinguish from bacterial sepsis, leading to high rates of antibiotic use. Early studies indicate low rates of secondary bacterial infections (SBIs) but have included heterogeneous patient populations. Here, we catalogue all SBIs and antibiotic prescription practices in a population of mechanically ventilated patients with COVID-19 induced acute respiratory distress syndrome (ARDS). Methods: This was a retrospective cohort study of all patients with COVID-19 ARDS requiring mechanical ventilation from 3 Seattle, Washington hospitals in 2020. Data were obtained via electronic and manual review of the electronic medical record. We report the incidence and site of SBIs, mortality, and antibiotics per day using descriptive statistics. Results: We identified 126 patients with COVID-19 induced ARDS during the study period. Of these patients, 61% developed clinical infection confirmed by bacterial culture. Ventilator associated pneumonia was confirmed in 55% of patients, bacteremia in 20%, and urinary tract infection (UTI) in 17%. Staphylococcus aureus was the most commonly isolated bacterial species. A total of 97% of patients received antibiotics during their hospitalization, and patients received nearly one antibiotic per day during their hospital stay. Conclusions: Mechanically ventilated patients with COVID-19 induced ARDS are at high risk for secondary bacterial infections and have extensive antibiotic exposure.
ISSN:0885-0666
1525-1489
DOI:10.1177/08850666211021745