Study of cases of Pseudomonas aeruginosa bacteria in patients with severe COVID-19

Abstract

Pseudomonas aeruginosa can cause severe nosocomial infections and sepsis, especially in immunocompromised comorbid patients.

The purpose of the study was to assess the frequency, clinical course, and the possibility of antimicrobial therapy for bloodstream infections caused by P. aeruginosa in patients with COVID-19.

Material and methods. A retrospective single-center uncontrolled study was performed from October 1, 2020 to September 31, 2021 on the basis of a temporary infectious diseases hospital for patients with COVID-19 at the City Clinical Hospital No. 52, Moscow. During the analyzed period, 16 047 patients were admitted to the infectious diseases hospital. The study included 46 patients over 18 years of age with a diagnosis of COVID-19 confirmed by PCR RNA SARS-CoV-2 nasopharyngeal swab (U 07.1) and/or computed tomography (CT) of the lungs (U 07.2). Statistical data processing was carried out using the BioStat, 2009 program (AnalystSoft, USA).

Results and discussion. P. aeruginosa has been isolated from the blood of 0.29% of patients with COVID-19. In the structure of bacteremia, P. aeruginosa accounted for 6.1%. In 87% of cases, pathogens were isolated from the blood of patients in the ICU. Most strains are classified as XDR phenotypes – 74% and MDR – 21.7%. The sensitivity of hospital strains of P. aeruginosa was: to colistin – 97%, to amikacin – 39.1%, meropenem – 32.6%. All patients had concomitant diseases: cardiovascular (60%), oncological (27.5%), diabetes mellitus (20%), obesity (22.5%) and others. In 47.5% of cases (19/40), the cause of bloodstream infections was ventilator-associated pneumonia. The mortality rate among patients with COVID-19 with P. aeruginosa bacteremia is 80%.

Conclusion. The wide distribution of multidrug-resistant strains of P. aeruginosa limits the number of therapeutic options. In severe bloodstream infections caused by P. aeruginosa XDR, combined antibiotic therapy regimens with the inclusion of polymyxin B are advisable.

Keywords:antibiotic resistance; bacteremia; bloodstream infections; ICU; ECMO; COVID-19; Pseudomonas aeruginosa

Funding. The study had no sponsor support.

Conflict of interest. The authors state that this work, its theme, subject and content do not affect competing interests.

Contribution. Collection and processing of material, statistical data processing, analysis of results, review of publications on the topic of the article, writing a text – Malygin A.S.; concept and design of the study, editing, approval of the final version of the article – Lysenko M.A.; analysis of results, editing – Tsarenko S.V.; collection and processing of material – Filimonova E.V. All authors took part in the discussion of the results.

For citation: Malygin A.S., Lysenko M.A., Tsarenko S.V., Filimonova E.V. Study of cases of Pseudomonas aeruginosa bacteria in patients with severe COVID-19. Infektsionnye bolezni: novosti, mneniya, obuchenie [Infectious Diseases: News, Opinions, Training]. 2022; 11 (4): 47–55. DOI: https://doi.org/10.33029/2305-3496-2022-11-4-47-55

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CHIEF EDITOR
Aleksandr V. Gorelov
Academician of the Russian Academy of Sciences, MD, Head of Infection Diseases and Epidemiology Department of the Scientific and Educational Institute of Clinical Medicine named after N.A. Semashko ofRussian University of Medicine, Ministry of Health of the Russian Federation, Professor of the Department of Childhood Diseases, Clinical Institute of Children's Health named after N.F. Filatov, Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Deputy Director for Research, Central Research Institute of Epidemiology, Rospotrebnadzor (Moscow, Russian Federation)

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