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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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| Published in: | Journal of intensive care medicine 2021-10, Vol.36 (10), p.1167-1175 |
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| Main Authors: | , , , , , , , , |
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| cites | cdi_FETCH-LOGICAL-c438t-360ac9c558cd634f1ac587695eeca0c71c81d9efc44c9d7f39f5752a8d02f453 |
| container_end_page | 1175 |
| container_issue | 10 |
| container_start_page | 1167 |
| container_title | Journal of intensive care medicine |
| container_volume | 36 |
| creator | Risa, Erik Roach, David Budak, Jehan Z. Hebert, Christopher Chan, Jeannie D. Mani, Nandita S. Bryson-Cahn, Chloe Town, James Johnson, Nicholas J. |
| description | 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. |
| doi_str_mv | 10.1177/08850666211021745 |
| format | article |
| fullrecord | <record><control><sourceid>sage_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8358424</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_08850666211021745</sage_id><sourcerecordid>10.1177_08850666211021745</sourcerecordid><originalsourceid>FETCH-LOGICAL-c438t-360ac9c558cd634f1ac587695eeca0c71c81d9efc44c9d7f39f5752a8d02f453</originalsourceid><addsrcrecordid>eNp9kd1qVDEUhYModqw-gDeSFzg1vyc5N8I4rTpQqdhaLw_pTtJJOZMMSUaYvk5f1AyjRRG8CmGt9e3NXgi9puSEUqXeEq0l6fueUUoYVUI-QTMqmeyo0MNTNNvr3d5whF6UckcI5YzT5-iIC66YYnSGHhYrkw1Ul8O9qSFFnDy-dJCiNXmH3x8kM-Fl9A72hoJNtHgea7gJqQbA34rDIeLPDlYmBjDTtMPXrumTqc7iLw3bfgV_D3WFFxfXy9OODo1nt9DkOWyrw19d2YRsamozT0Op2ZWCL3fR5rR2L9Ezb6biXv16j9HVh7Orxafu_OLjcjE_70BwXTveEwMDSKnB9lx4akBq1Q_SOTAEFAVN7eA8CAGDVZ4PXirJjLaEeSH5MXp3wG62N2tnoS2dzTRucli3U4zJhPFvJYbVeJt-jJpLLZhoAHoAQE6lZOcfs5SM-8LGfwprmTd_Dn1M_G6oGU4OhmJu3XiXtjm2G_yH-BPDBKJj</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Characterization of Secondary Bacterial Infections and Antibiotic Use in Mechanically Ventilated Patients With COVID-19 Induced Acute Respiratory Distress Syndrome</title><source>Sage Journals Online</source><creator>Risa, Erik ; Roach, David ; Budak, Jehan Z. ; Hebert, Christopher ; Chan, Jeannie D. ; Mani, Nandita S. ; Bryson-Cahn, Chloe ; Town, James ; Johnson, Nicholas J.</creator><creatorcontrib>Risa, Erik ; Roach, David ; Budak, Jehan Z. ; Hebert, Christopher ; Chan, Jeannie D. ; Mani, Nandita S. ; Bryson-Cahn, Chloe ; Town, James ; Johnson, Nicholas J.</creatorcontrib><description>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.</description><identifier>ISSN: 0885-0666</identifier><identifier>EISSN: 1525-1489</identifier><identifier>DOI: 10.1177/08850666211021745</identifier><identifier>PMID: 34372721</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>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</subject><ispartof>Journal of intensive care medicine, 2021-10, Vol.36 (10), p.1167-1175</ispartof><rights>The Author(s) 2021</rights><rights>The Author(s) 2021 2021 SAGE Publications</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-360ac9c558cd634f1ac587695eeca0c71c81d9efc44c9d7f39f5752a8d02f453</citedby><cites>FETCH-LOGICAL-c438t-360ac9c558cd634f1ac587695eeca0c71c81d9efc44c9d7f39f5752a8d02f453</cites><orcidid>0000-0001-9915-0591 ; 0000-0001-5199-0452</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,786,790,891,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34372721$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Risa, Erik</creatorcontrib><creatorcontrib>Roach, David</creatorcontrib><creatorcontrib>Budak, Jehan Z.</creatorcontrib><creatorcontrib>Hebert, Christopher</creatorcontrib><creatorcontrib>Chan, Jeannie D.</creatorcontrib><creatorcontrib>Mani, Nandita S.</creatorcontrib><creatorcontrib>Bryson-Cahn, Chloe</creatorcontrib><creatorcontrib>Town, James</creatorcontrib><creatorcontrib>Johnson, Nicholas J.</creatorcontrib><title>Characterization of Secondary Bacterial Infections and Antibiotic Use in Mechanically Ventilated Patients With COVID-19 Induced Acute Respiratory Distress Syndrome</title><title>Journal of intensive care medicine</title><addtitle>J Intensive Care Med</addtitle><description>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.</description><subject>Anti-Bacterial Agents - adverse effects</subject><subject>Bacterial Infections</subject><subject>COVID-19</subject><subject>Humans</subject><subject>Original Research</subject><subject>Respiration, Artificial</subject><subject>Respiratory Distress Syndrome - chemically induced</subject><subject>Respiratory Distress Syndrome - therapy</subject><subject>Retrospective Studies</subject><subject>SARS-CoV-2</subject><issn>0885-0666</issn><issn>1525-1489</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><recordid>eNp9kd1qVDEUhYModqw-gDeSFzg1vyc5N8I4rTpQqdhaLw_pTtJJOZMMSUaYvk5f1AyjRRG8CmGt9e3NXgi9puSEUqXeEq0l6fueUUoYVUI-QTMqmeyo0MNTNNvr3d5whF6UckcI5YzT5-iIC66YYnSGHhYrkw1Ul8O9qSFFnDy-dJCiNXmH3x8kM-Fl9A72hoJNtHgea7gJqQbA34rDIeLPDlYmBjDTtMPXrumTqc7iLw3bfgV_D3WFFxfXy9OODo1nt9DkOWyrw19d2YRsamozT0Op2ZWCL3fR5rR2L9Ezb6biXv16j9HVh7Orxafu_OLjcjE_70BwXTveEwMDSKnB9lx4akBq1Q_SOTAEFAVN7eA8CAGDVZ4PXirJjLaEeSH5MXp3wG62N2tnoS2dzTRucli3U4zJhPFvJYbVeJt-jJpLLZhoAHoAQE6lZOcfs5SM-8LGfwprmTd_Dn1M_G6oGU4OhmJu3XiXtjm2G_yH-BPDBKJj</recordid><startdate>20211001</startdate><enddate>20211001</enddate><creator>Risa, Erik</creator><creator>Roach, David</creator><creator>Budak, Jehan Z.</creator><creator>Hebert, Christopher</creator><creator>Chan, Jeannie D.</creator><creator>Mani, Nandita S.</creator><creator>Bryson-Cahn, Chloe</creator><creator>Town, James</creator><creator>Johnson, Nicholas J.</creator><general>SAGE Publications</general><scope>AFRWT</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-9915-0591</orcidid><orcidid>https://orcid.org/0000-0001-5199-0452</orcidid></search><sort><creationdate>20211001</creationdate><title>Characterization of Secondary Bacterial Infections and Antibiotic Use in Mechanically Ventilated Patients With COVID-19 Induced Acute Respiratory Distress Syndrome</title><author>Risa, Erik ; Roach, David ; Budak, Jehan Z. ; Hebert, Christopher ; Chan, Jeannie D. ; Mani, Nandita S. ; Bryson-Cahn, Chloe ; Town, James ; Johnson, Nicholas J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-360ac9c558cd634f1ac587695eeca0c71c81d9efc44c9d7f39f5752a8d02f453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Anti-Bacterial Agents - adverse effects</topic><topic>Bacterial Infections</topic><topic>COVID-19</topic><topic>Humans</topic><topic>Original Research</topic><topic>Respiration, Artificial</topic><topic>Respiratory Distress Syndrome - chemically induced</topic><topic>Respiratory Distress Syndrome - therapy</topic><topic>Retrospective Studies</topic><topic>SARS-CoV-2</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Risa, Erik</creatorcontrib><creatorcontrib>Roach, David</creatorcontrib><creatorcontrib>Budak, Jehan Z.</creatorcontrib><creatorcontrib>Hebert, Christopher</creatorcontrib><creatorcontrib>Chan, Jeannie D.</creatorcontrib><creatorcontrib>Mani, Nandita S.</creatorcontrib><creatorcontrib>Bryson-Cahn, Chloe</creatorcontrib><creatorcontrib>Town, James</creatorcontrib><creatorcontrib>Johnson, Nicholas J.</creatorcontrib><collection>SAGE Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of intensive care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Risa, Erik</au><au>Roach, David</au><au>Budak, Jehan Z.</au><au>Hebert, Christopher</au><au>Chan, Jeannie D.</au><au>Mani, Nandita S.</au><au>Bryson-Cahn, Chloe</au><au>Town, James</au><au>Johnson, Nicholas J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Characterization of Secondary Bacterial Infections and Antibiotic Use in Mechanically Ventilated Patients With COVID-19 Induced Acute Respiratory Distress Syndrome</atitle><jtitle>Journal of intensive care medicine</jtitle><addtitle>J Intensive Care Med</addtitle><date>2021-10-01</date><risdate>2021</risdate><volume>36</volume><issue>10</issue><spage>1167</spage><epage>1175</epage><pages>1167-1175</pages><issn>0885-0666</issn><eissn>1525-1489</eissn><abstract>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.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>34372721</pmid><doi>10.1177/08850666211021745</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-9915-0591</orcidid><orcidid>https://orcid.org/0000-0001-5199-0452</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of intensive care medicine, 2021-10, Vol.36 (10), p.1167-1175 |
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| language | eng |
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| source | Sage Journals Online |
| 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 |
| title | Characterization of Secondary Bacterial Infections and Antibiotic Use in Mechanically Ventilated Patients With COVID-19 Induced Acute Respiratory Distress Syndrome |
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