In this study, we aimed to evaluate the epidemiology and antimicrobial resistance (AMR) patterns of bacterial pathogens in COVID-19 patients and to compare the results with control groups from the pre-pandemic and pandemic era. Microbiological database records of all the COVID-19 diagnosed patients in the Ege University Hospital between March 15, 2020, and June 15, 2020, evaluated retrospectively. Patients who acquired secondary bacterial infections (SBIs) and bacterial co-infections were analyzed. Etiology and AMR data of the bacterial infections were collected. Results were also compared to control groups from pre-pandemic and pandemic era data. In total, 4859 positive culture results from 3532 patients were analyzed. Fifty-two (3.59%) patients had 78 SBIs and 38 (2.62%) patients had 45 bacterial co-infections among 1447 COVID-19 patients. 22/85 (25.88%) patients died who had bacterial infections. The respiratory culture-positive sample rate was 39.02% among all culture-positive samples in the COVID-19 group. There was a significant decrease in extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales (8.94%) compared to samples from the pre-pandemic (20.76%) and pandemic era (20.74%) (p = 0.001 for both comparisons). Interestingly, Acinetobacter baumannii was the main pathogen in the respiratory infections of COVID-19 patients (9.76%) and the rate was significantly higher than pre-pandemic (3.49%, p < 0.002) and pandemic era control groups (3.11%, p < 0.001). Due to the low frequency of SBIs reported during the ongoing pandemic, a more careful and targeted antimicrobial prescription should be taken. While patients with COVID-19 had lower levels of ESBL-producing Enterobacterales, the frequency of multidrug-resistant (MDR) A. baumannii is higher.

中文翻译：

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COVID-19 中的继发细菌感染和抗菌药物耐药性：大流行前和大流行时代的比较评估，一项回顾性单中心研究

在这项研究中，我们旨在评估 COVID-19 患者细菌病原体的流行病学和抗菌素耐药性 (AMR) 模式，并将结果与​​大流行前和大流行时代的对照组进行比较。对2020年3月15日至2020年6月15日期间埃格大学医院所有确诊的COVID-19患者的微生物数据库记录进行了回顾性评估。对继发细菌感染（SBI）和细菌合并感染的患者进行了分析。收集细菌感染的病原学和 AMR 数据。还将结果与大流行前和大流行时代数据的对照组进行了比较。总共分析了 3532 名患者的 4859 份阳性培养结果。在 1447 名 COVID-19 患者中，52 名 (3.59%) 名患者出现 78 例 SBI，38 名 (2.62%) 名患者出现 45 名细菌合并感染。22/85 (25.88%) 患者死于细菌感染。COVID-19组所有培养阳性样本中呼吸道培养阳性样本率为39.02%。与大流行前 (20.76%) 和大流行时代 (20.74%) 的样本相比，产生超广谱 β-内酰胺酶 (ESBL) 的肠杆菌 (8.94%) 显着减少（两次比较 p = 0.001）。有趣的是，鲍曼不动杆菌是COVID-19患者呼吸道感染的主要病原体（9.76%），其发病率显着高于大流行前（3.49%，p < 0.002）和大流行时代对照组（3.11%，p < 0.001）。由于大流行期间报告的 SBI 频率较低，因此应采取更加谨慎和有针对性的抗菌处方。虽然 COVID-19 患者的产 ESBL 肠杆菌水平较低，但多重耐药 (MDR) 鲍曼不动杆菌的频率较高。