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COVID-19: Bacterial and Fungal Co-infections in Hospitalised Patients

A new study suggests a low frequency of bacterial and fungal co-infections in patients hospitalised with COVID-19 in the UK. The findings were published in the journal Clinical Microbiology and Infection.

Researchers retrospectively analysed hospitalised patients with confirmed SARS-CoV-2 infection (n=836) across two acute NHS hospitals. A control group of patients with influenza admitted during the 2019-2020 flu season at the same sites was also analysed.

Among the patients admitted with confirmed SARS-CoV-2 infection, only a few other clinically meaningful pathogens were isolated. Two Gram negatives, one community-acquired Klebsiella pneumoniae and one ventilator-associated Enterobacter cloacae were attributed to respiratory source. One Pseudomonas aeruginosa, two Enterococcus spp. and three Candida albicans infections were attributed to central line source, and one Escherichia coli infection was attributed to urinary catheter source. The rest of the bacteraemias were community onset and attributable to non-respiratory infections. Rates of positive co-infection in the control group were comparable.

The authors recommend: "Antibacterial therapy, if indicated, should be prescribed in line with local guidelines and reviewed with clinical response at 48-72 hours. If no evidence of bacterial coinfection, cessation of antibacterial therapy should be considered." They also call for further research to better understand the incidence, nature and impact of late secondary bacterial and fungal infections.