The clinical impact of bacterial co-infection among moderate, severe and critically ill COVID-19 patients in the second referral hospital in Surabaya
Tri Pudy Asmarawati, Alfian Nur Rosyid, Satriyo Dwi Suryantoro, Bagus Aulia Mahdi, Choirina Windradi, Prastuti Asta Wulaningrum, Muhammad Vitanata Arifijanto, Bramantono Bramantono, Erwin Astha Triyono, Musofa Rusli, Brian Eka Rachman, Erika Marfiani, Pepy Dwi Endraswari, Usman Hadi, Kuntaman Kuntaman, Nasronudin Nasronudin
Abstract
<b>Background:</b> 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. <b>Methods:</b> This study is a cross sectional study with retrospective approach, 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. <b>Results:</b> 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%). <b>Conclusion:</b> 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.