Impact of Bacterial Infections and Antibiotic Use on Hospitalized COVID-19 Patients: An Emerging Infections Network Survey

Abstract

The SARS-CoV-2 pandemic has had a significant impact on the United States healthcare system. This is exacerbated by antimicrobial-resistant bacterial pathogens endemic to healthcare settings. Respiratory viral infections are known to predispose patients to bacterial infections, which were a major contributor to mortality in previous pandemics. This study’s goal was to gain an understanding of bacterial infections in hospitalized COVID-19 patients. A case form for COVID-19 patients with bacterial infections was developed and sent to clinicians on the Emerging Infections Network listserv. The case form included 22 questions on patient demographics, COVID-19 and bacterial infection and treatment, and patient outcome. One hundred and nine patient cases were collected and analyzed. The majority of patients (59.6%) were critically ill, and 66.9% of patients were diagnosed with sepsis. Empiric and directed antibiotics were administered to 81.6% and 94.5% of patients, respectively. Thirty-one infections were not resolved with antibiotics, and of those patients, 74.2% died. Unresolved bacterial infections were found to be a significant contributor to mortality in this case series. These bacterial infections can most likely be attributed to long hospital stays and exposure to nosocomial pathogens. Thus, unresolved nosocomial bacterial infections warrant additional attention during future events where there is a strain on the US healthcare system.