ArticleBMC pulmonary medicine2023
Risk factors and effect on mortality of superinfections in a newly established COVID-19 respiratory sub-intensive care unit at University Hospital in Rome.
Article in BMC pulmonary medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 26 citations in OpenAlex.
- Characteristics of Klebsiella pneumoniae and carbapenem-resistant Klebsiella pneumoniae clinical isolates from COVID-19 patients: a single-center retrospective analysis in a tertiary hospital, China.BMC infectious diseases · 2025Article
- The burden of nosocomial superinfections in a retrospective cohort study of critically ill COVID-19 patients.BMC infectious diseases · 2025Article
- Epidemiology, Ventilation Management, and Outcomes in Invasively Ventilated Coronavirus Disease 2019 Patients: An Analysis of Four Observational Studies in Four Countries on Two Continents.The American journal of tropical medicine and hygiene · 2025Observational
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- Phenotypic and genotypic characterization of clinical carbapenem-resistantMicrobiology spectrum · 2025Article
- Treatment with proton pump inhibitors is associated with secondary bacterial infections and sepsis in patients with COVID-19: a retrospective analysis of their joint impact on in-hospital prognosis.Annals of medicine · 2024Article
- Revisiting the COVID-19 Pandemic: Mortality and Predictors of Death in Adult Patients in the Intensive Care Unit.Life (Basel, Switzerland) · 2024Article
- Bacterial Community- and Hospital-Acquired Pneumonia in Patients with Critical COVID-19-A Prospective Monocentric Cohort Study.Antibiotics (Basel, Switzerland) · 2024Article
- Antimicrobial resistance genes harbored in invasiveFrontiers in cellular and infection microbiology · 2024Article
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- Risk factors for carbapenem-resistantJAC-antimicrobial resistance · 2023Article
- Inhalation phage therapy as a new approach to preventing secondary bacterial pneumonia in patients with moderate to severe COVID-19: A double-blind clinical trial study.Journal of drug delivery science and technology · 2023Article
- Prevalence and mortality rate of healthcare-associated infections among COVID-19 patients: a retrospective cohort community-based approach.Frontiers in public health · 2023Observational
- Review
- Secondary pulmonary infection and co-infection in elderly COVID-19 patients during the pandemics in a tertiary general hospital in Beijing, China.Frontiers in microbiology · 2023Article
- Characteristics and risk factors of secondary bacterial infections in COVID-19 patients.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- The impact of bacterial superinfections on the outcome of critically ill patients with COVID-19 associated acute respiratory distress syndrome (ARDS) - a single-centre, observational cohort study.Anaesthesiology intensive therapy · 2023Observational
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLittle is known on the burden of co-infections and superinfections in a specific setting such as the respiratory COVID-19 sub-intensive care unit. This study aims to (i) assess the prevalence of concurrent and superinfections in a respiratory sub-intensive care unit, (ii) evaluate the risk factors for superinfections development and (iii) assess the impact of superinfections on in-hospital mortality.
methodsSingle-center retrospective analysis of prospectively collected data including COVID-19 patients hospitalized in a newly established respiratory sub-intensive care unit managed by pneumologists which has been set up from September 2020 at a large (1200 beds) University Hospital in Rome. Inclusion criteria were: (i) COVID-19 respiratory failure and/or ARDS; (ii) hospitalization in respiratory sub-intensive care unit and (iii) age > 18 years. Survival was analyzed by Kaplan-Meier curves and the statistical significance of the differences between the two groups was assessed using the log-rank test. Multivariable logistic regression and Cox regression model were performed to tease out the independent predictors for superinfections' development and for mortality, respectively.
resultsA total of 201 patients were included. The majority (106, 52%) presented severe COVID-19. Co-infections were 4 (1.9%), whereas 46 patients (22%) developed superinfections, mostly primary bloodstream infections and pneumonia. In 40.6% of cases, multi-drug resistant pathogens were detected, with carbapenem-resistant Acinetobacter baumannii (CR-Ab) isolated in 47%. Overall mortality rate was 30%. Prior (30-d) infection and exposure to antibiotic therapy were independent risk factors for superinfection development whereas the development of superinfections was an independent risk factors for in-hospital mortality. CR-Ab resulted independently associated with 14-d mortality.
conclusionIn a COVID-19 respiratory sub-intensive care unit, superinfections were common and represented an independent predictor of mortality. CR-Ab infections occurred in almost half of patients and were associated with high mortality. Infection control rules and antimicrobial stewardship are crucial in this specific setting to limit the spread of multi-drug resistant organisms.
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