Background We defined the frequency of respiratory community-acquired bacterial co-infection in patients with COVID-19, i.e. patients with a positive SARS-CoV-2 PCR or a COVID-19 Reporting and Data System (CO-RADS) score ≥ 4, based on a complete clinical assessment, including prior antibiotic use, clinical characteristics, inflammatory markers, chest computed tomography (CT) results and microbiological test results. Methods Our retrospective study was conducted within a cohort of prospectively included patients admitted for COVID-19 in our tertiary medical centres between 1-3-2020 and 1-6-2020. A multidisciplinary study team developed a diagnostic protocol to retrospectively categorize patients as unlikely, possible or probable bacterial co-infection based on clinical, radiological and microbiological parameters in the first 72 h of admission. Within the three categories, we summarized patient characteristics and antibiotic consumption. Results Among 281 included COVID-19 patients, bacterial co-infection was classified as unlikely in 233 patients (82.9%), possible in 35 patients (12.4%) and probable in 3 patients (1.1%). Ten patients (3.6%) could not be classified due to inconclusive data. Within 72 h of hospital admission, 81% of the total study population and 78% of patients classified as unlikely bacterial co-infection received antibiotics. Conclusions COVID-19 patients are unlikely to have a respiratory community-acquired bacterial co-infection. This study underpins recommendations for restrictive use of antibacterial drugs in patients with COVID-19. Supplementary Information The online version contains supplementary material available at 10.1186/s13756-021-01024-4.
【저자키워드】 COVID-19, SARS-CoV-2, Co-infection, Antimicrobial stewardship, community-acquired pneumonia, antimicrobial use, 【초록키워드】 Clinical characteristics, inflammatory markers, Antibiotics, drug, Chest computed tomography, Retrospective study, Cohort, Characteristics, Patient, Reporting, Hospital admission, Admission, bacterial co-infection, antibiotic use, COVID-19 patients, antibiotic, Frequency, COVID-19 patient, supplementary material, study population, categories, positive SARS-CoV-2 PCR, diagnostic protocol, parameter, Complete, Inconclusive, recommendation, System, radiological, Result, defined, conducted, unlikely, patients with COVID-19, 【제목키워드】 bacterial co-infection, low frequency, retrospective cohort study, radiological, patients hospitalized,