EC Clinical and Medical Case Reports

Background and Objectives: The COVID pandemic not only increased the global healthcare burden, but also escalated the risk of pneumonia and acute respiratory distress syndrome (ADRS) among the hospitalized individuals. Hence, we planned this study to determine the bacterial sources of infection among the hospitalized COVID patients. We also gauged the sensitivity patterns observed among the participants.

Methods: In this retrospective study, we screened all the bacterial culture-positive samples of patients diagnosed with COVID-19 infection and hospitalized between April 2020 and August 2021. Of them, we analyzed only the culture reports of adult patients with pneumonia and/or acute respiratory distress syndrome (ARDS) due to a single causative microorganism. The bacteria identification and susceptibility testing were performed with VITEK 2. We assessed the diagnosis and outcome of female and male participants. Moreover, we analyzed the antimicrobial susceptibility of the participants with forty antibiotics. R software (version 4.4.1) was leveraged for the data analysis.

Results: We analyzed the data of 1980 eligible patients. Of them, 1114 (56.3%) were females. The median age of the study population was 48.0 (38.0-62.0) years. The most common causative bacteria were Staphylococcus aureus (517, 26.1%), followed by E. coli (332, 16.8%), Acinetobacter baumannii (260, 13.1%), Klebsiella pneumoniae (159, 8.0%), Pseudomonas aeruginosa (146, 7.4%), Streptococcus spp. (118, 6.0%), and Enterobacter spp. (110, 5.6%). The majority of our study participants (1341, 67.7%) were diagnosed with pneumonia. The cure rate was 87.5% in the study population. The culture sensitivity patterns were similar across the gender.

Conclusion: Our study showed that middle-aged individuals were more affected with respiratory infections. We noted multiple microorganisms as cause of those infections. The antimicrobial susceptibility findings were similar among females and males. Moreover, the cure rate was considerably high.

 Keywords: COVID Pandemic; Pneumonia; Respiratory Distress; Bacterial Infection; Culture and Sensitivity; Antibiotics

1. Chang Raymond., et al. “COVID-19 ICU and mechanical ventilation patient characteristics and outcomes-A systematic review and meta-analysis”. PloS one2 (2021): e0246318.
2. Sahoo Jyoti Prakash., et al. "Predict the hospitalization in COVID-19: Magic is in the air”. National Journal of Physiology, Pharmacy and Pharmacology4 (2022): 432-440.
3. Bustos Ingrid G., et al. “Exploring the complex relationship between the lung microbiome and ventilator-associated pneumonia”. Expert Review of Respiratory Medicine10 (2023): 889-901.
4. Bellani Giacomo., et al. “Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries”. JAMA8 (2016): 788-800.
5. Kassirian Shayan., et al. "Diagnosis and management of acute respiratory distress syndrome in a time of COVID-19”. Diagnostics 12 (2020): 1053.
6. Chen Nanshan., et al. “Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study”. Lancet (London, England) 10223 (2020): 507-513.
7. Ramji Husayn F., et al. “Acute Respiratory Distress Syndrome; A Review of Recent Updates and a Glance into the Future”. Diagnostics (Basel, Switzerland)9 (2023): 1528.
8. Fan Eddy., et al. “COVID-19-associated acute respiratory distress syndrome: is a different approach to management warranted?” The Lancet Respiratory Medicine 8 (2020): 816-821.
9. Eshwara Vandana Kalwaje., et al. “Community-acquired bacterial pneumonia in adults: An update”. The Indian Journal of Medical Research 4 (2020): 287-302.
10. Acharya Vishak K., et al. “Microbiological profile and drug sensitivity pattern among community acquired pneumonia patients in tertiary care centre in Mangalore, Coastal Karnataka, India”. Journal of Clinical and Diagnostic Research: JCDR6 (2014): MC04-MC06.
11. Tilahun Mihret., et al. “Etiology of bacterial pneumonia and multi-drug resistance pattern among pneumonia suspected patients in Ethiopia: a systematic review and meta-analysis”. BMC Pulmonary Medicine1 (2024): 182.
12. R Core Team. R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing (2020).
13. Zubieta-Calleja Gustavo R., et al. “Morphological and functional findings in COVID-19 lung disease as compared to pneumonia, ARDS, and high-altitude pulmonary edema”. Respiratory Physiology and Neurobiology 309 (2023): 104000.
14. Sturgill Jamie L., et al. “Post-intensive care syndrome and pulmonary fibrosis in patients surviving ARDS-pneumonia of COVID-19 and non-COVID-19 etiologies”. Scientific Reports1 (2023): 6554.
15. Belizário José., et al. “Lung microbiome and origins of the respiratory diseases”. Current Research in Immunology 4 (2023): 100065.
16. Xu Huikang., et al. “Acute respiratory distress syndrome heterogeneity and the septic ARDS subgroup”. Frontiers in Immunology 14 (2023): 1277161.
17. Roe Kevin. “Deadly interactions: Synergistic manipulations of concurrent pathogen infections potentially enabling future pandemics”. Drug Discovery Today11 (2023): 103762.
18. Kang Liangyu., et al. “Trends of global and regional aetiologies, risk factors and mortality of lower respiratory infections from 1990 to 2019: An analysis for the Global Burden of Disease Study 2019”. Respirology (Carlton, Vic.) 2 (2023): 166-175.
19. Safiri Saeid., et al. “Global burden of lower respiratory infections during the last three decades”. Frontiers in Public Health 10 (2023): 1028525.
20. Santella Biagio., et al. “Lower respiratory tract pathogens and their antimicrobial susceptibility pattern: A 5-year study”. Antibiotics (Basel, Switzerland)7 (2021): 851.
21. Chung Hattie., et al. “Rapid expansion and extinction of antibiotic resistance mutations during treatment of acute bacterial respiratory infections”. Nature Communications1 (2022): 1231.