Bacterial coinfections in COVID-19: an underestimated adversary

Ann Ist Super Sanita. 2020 Jul-Sep;56(3):359-364. doi: 10.4415/ANN_20_03_14.

Abstract

Current literature shows that secondary bacterial infections, although less frequent than in previous influenza pandemics, affect COVID-19 patients. Mycoplasma pneumoniae, Staphylococcus aureus, Legionella pneumophila, Streptococcus pneumoniae, Haemophilus and Klebsiella spp. are the main species isolated. Of note, Mycobacterium tuberculosis-COVID-19 coinfections are also reported. However, bacterial coinfection rates increase in patients admitted in the intensive care units, and those diseases can be due to super-infections by nosocomial antibiotic-resistant bacteria. This highlights the urgency to revise frequent and empiric prescription of broad-spectrum antibiotics in COVID-19 patients, with more attention to evidence-based studies and respect for the antimicrobial stewardship principles.

MeSH terms

  • Antimicrobial Stewardship
  • Bacterial Infections / drug therapy
  • Bacterial Infections / epidemiology*
  • Bacterial Infections / microbiology
  • Bacterial Infections / transmission
  • Betacoronavirus*
  • COVID-19
  • Coinfection / epidemiology*
  • Coronavirus Infections / epidemiology*
  • Cross Infection / epidemiology
  • Cross Infection / transmission
  • Drug Resistance, Microbial
  • Early Diagnosis
  • Humans
  • Intensive Care Units
  • Italy / epidemiology
  • Mycoses / epidemiology
  • Pandemics*
  • Pneumonia, Viral / epidemiology*
  • Respiratory Tract Infections / epidemiology
  • Respiratory Tract Infections / microbiology
  • SARS-CoV-2
  • Species Specificity
  • Tuberculosis / epidemiology