The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide. Bacterial co-infections are associated with unfavourable outcomes in respiratory viral infections; however, microbiological and antibiotic data related to COVID-19 are sparse. Adequate use of antibiotics in line with antibiotic stewardship (ABS) principles is warranted during the pandemic. We performed a retrospective study of clinical and microbiological characteristics of 140 COVID-19 patients admitted between February and April 2020 to a German University hospital, with a focus on bacterial co-infections and antimicrobial therapy. The final date of follow-up was 6 May 2020. Clinical data of 140 COVID-19 patients were recorded: The median age was 63.5 (range 17–99) years; 64% were males. According to the implemented local ABS guidelines, the most commonly used antibiotic regimen was ampicillin/sulbactam (41.5%) with a median duration of 6 (range 1–13) days. Urinary antigen tests for Legionella pneumophila and Streptococcus peumoniae were negative in all cases. In critically ill patients admitted to intensive care units (n = 50), co-infections with Enterobacterales (34.0%) and Aspergillus fumigatus (18.0%) were detected. Blood cultures collected at admission showed a diagnostic yield of 4.2%. Bacterial and fungal co-infections are rare in COVID-19 patients and are mainly prevalent in critically ill patients. Further studies are needed to assess the impact of antimicrobial therapy on therapeutic outcome in COVID-19 patients to prevent antimicrobial overuse. ABS guidelines could help in optimising the management of COVID-19. Investigation of microbial patterns of infectious complications in critically ill COVID-19 patients is also required.

由严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 引起的 2019 年冠状病毒病 (COVID-19) 已在全球范围内传播。细菌合并感染与呼吸道病毒感染的不良后果有关；然而，与 COVID-19 相关的微生物学和抗生素数据很少。在大流行期间，需要根据抗生素管理 (ABS) 原则充分使用抗生素。我们对 2020 年 2 月至 4 月期间德国大学医院收治的 140 名 COVID-19 患者的临床和微生物学特征进行了回顾性研究，重点关注细菌合并感染和抗菌治疗。最终随访日期为2020年5月6日。记录了140名COVID-19患者的临床数据：中位年龄为63.5岁（范围17-99岁）；64%是男性。根据当地实施的 ABS 指南，最常用的抗生素治疗方案是氨苄青霉素/舒巴坦 (41.5%)，中位持续时间为 6 天（范围 1-13）天。所有病例的尿嗜肺军团菌和肺炎链球菌抗原检测均为阴性。在重症监护病房收治的危重患者中（n = 50），检测到肠杆菌（34.0%）和烟曲霉（18.0%） 混合感染。入院时收集的血培养显示诊断率为 4.2%。细菌和真菌合并感染在 COVID-19 患者中很少见，主要常见于危重患者。需要进一步研究来评估抗菌药物治疗对 COVID-19 患者治疗结果的影响，以防止抗菌药物过度使用。ABS 指南有助于优化 COVID-19 的管理。还需要对重症 COVID-19 患者感染并发症的微生物模式进行调查。