Bacterial and fungal co-infection has been reported in patients with COVID-19, but there is limited experience on these infections in critically ill patients. The objective of this study was to assess the characteristics and ouctome of ICU-acquired infections in COVID-19 patients. We conducted a retrospective single-centre, case-control study including 140 patients with severe COVID-19 admitted to the ICU between March and May 2020. We evaluated the epidemiological, clinical, and microbiological features, and outcome of ICU-acquired infections. Fifty-seven patients (40.7%) developed a bacterial or fungal nosocomial infection during ICU stay. Infection occurred after a median of 9 days (IQR 5–11) of admission and was significantly associated with the APACHE II score (p = 0.02). There were 91 episodes of infection: primary (31%) and catheter-related (25%) bloodstream infections were the most frequent, followed by pneumonia (23%), tracheobronchitis (10%), and urinary tract infection (8%) that were produced by a wide spectrum of Gram-positive (55%) and Gram-negative bacteria (30%) as well as fungi (15%). In 60% of cases, infection was associated with septic shock and a significant increase in SOFA score. Overall ICU mortality was 36% (51/140). Infection was significantly associated with death (OR 2.7, 95% CI 1.2–5.9, p = 0.015) and a longer ICU stay (p < 0.001). Bacterial and fungal nosocomial infection is a common complication of ICU admission in patients with COVID-19. It usually presents as a severe form of infection, and it is associated with a high mortality and longer course of ICU stay.

据报道，COVID-19 患者存在细菌和真菌双重感染，但针对重症患者这些感染的经验有限。本研究的目的是评估 COVID-19 患者 ICU 获得性感染的特征和结果。我们进行了一项回顾性单中心病例对照研究，纳入了 2020 年 3 月至 5 月入住 ICU 的 140 名重症 COVID-19 患者。我们评估了 ICU 获得性感染的流行病学、临床和微生物学特征以及结果。 57 名患者（40.7%）在 ICU 住院期间出现细菌或真菌院内感染。感染发生在入院平均 9 天 (IQR 5-11) 后，与 APACHE II 评分显着相关 ( p = 0.02)。共有 91 次感染：原发性（31%）和导管相关（25%）血流感染最常见，其次是肺炎（23%）、气管支气管炎（10%）和尿路感染（8%）。由多种革兰氏阳性菌（55%）和革兰氏阴性菌（30%）以及真菌（15%）产生。在 60% 的病例中，感染与感染性休克和 SOFA 评分显着增加有关。 ICU 总体死亡率为 36% (51/140)。感染与死亡（OR 2.7，95% CI 1.2-5.9， p = 0.015）和更长的 ICU 住院时间（ p < 0.001）显着相关。细菌和真菌院内感染是 COVID-19 患者入住 ICU 的常见并发症。它通常表现为一种严重的感染形式，并且与高死亡率和较长的 ICU 住院时间有关。