Multidrug-Resistant Infections and Outcome of Critically Ill Patients with Coronavirus Disease 2019: A Single Center Experience
Karruli et al.,
Multidrug-Resistant Infections and Outcome of Critically Ill Patients with Coronavirus Disease 2019: A Single..,
Microbial Drug Resistance, doi:10.1089/mdr.2020.0489
Retrospective 32 ICU patients showing lower mortality with aspirin treatment, without statistical significance.
risk of death, 46.3% lower, RR 0.54, p = 0.63, treatment 1 of 5 (20.0%), control 22 of 27 (81.5%), NNT 1.6, adjusted per study, odds ratio converted to relative risk, multivariable.
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Karruli et al., 1 Sep 2021, retrospective, Italy, peer-reviewed, 13 authors, study period March 2020 - May 2020.
Abstract: MICROBIAL DRUG RESISTANCE
Volume 27, Number 9, 2021
ª Mary Ann Liebert, Inc.
DOI: 10.1089/mdr.2020.0489
Multidrug-Resistant Infections and Outcome
of Critically Ill Patients with Coronavirus Disease 2019:
A Single Center Experience
Arta Karruli,1 Filomena Boccia,1 Massimo Gagliardi,1 Fabian Patauner,1 Maria Paola Ursi,1 Pino Sommese,1
Rosanna De Rosa,2 Patrizia Murino,2 Giuseppe Ruocco,3 Antonio Corcione,2 Roberto Andini,4
Rosa Zampino,4,5 and Emanuele Durante-Mangoni1,4
Background: The aim of this study was to assess the drivers of multidrug-resistant (MDR) bacterial infection
development in coronavirus disease 2019 (COVID-19) and its impact on patient outcome.
Methods: Retrospective analysis on data from 32 consecutive patients with COVID-19, admitted to our intensive
care unit (ICU) from March to May 2020. Outcomes considered were MDR infection and ICU mortality.
Results: Fifty percent of patients developed an MDR infection during ICU stay after a median time of 8 [4–11]
days. Most common MDR pathogens were carbapenem-resistant Klebsiella pneumoniae and Acinetobacter
baumannii, causing bloodstream infections and pneumonia. MDR infections were linked to a higher length of
ICU stay ( p = 0.002), steroid therapy ( p = 0.011), and associated with a lower ICU mortality (odds ratio: 0.439,
95% confidence interval: 0.251–0.763; p < 0.001). Low-dose aspirin intake was associated with both MDR
infection ( p = 0.043) and survival ( p = 0.015). Among MDR patients, mortality was related with piperacillintazobactam use ( p = 0.035) and an earlier onset of MDR infection ( p = 0.042).
Conclusions: MDR infections were a common complication in critically ill COVID-19 patients at our center.
MDR risk was higher among those dwelling longer in the ICU and receiving steroids. However, MDR infections were not associated with a worse outcome.
Keywords: MDR, COVID-19, SARS-CoV-2, ICU, outcome
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