Objectives SARS-CoV-2 may cause acute lung injury, and secondary infections are thus relevant complications in patients with COVID-19 pneumonia. However, detailed information on community- and hospital-acquired infections among patients with COVID-19 pneumonia is scarce. Methods We identified 220 SARS-CoV-2-positive patients hospitalized at the University Hospital Basel, Switzerland (between 25 February and 31 May 2020). We excluded patients who declined the general consent ( n = 12), patients without clinical evidence of pneumonia ( n = 29), and patients hospitalized for < 24 h ( n = 17). We evaluated the frequency of community- and hospital-acquired infections using respiratory and blood culture materials with antigen, culture-based, and molecular diagnostics. For ICU patients, all clinical and microbial findings were re-evaluated interdisciplinary (intensive care, infectious disease, and clinical microbiology), and agreement reached to classify patients with infections. Results In the final cohort of 162 hospitalized patients (median age 64.4 years (IQR, 50.4–74.2); 61.1% male), 41 (25.3%) patients were admitted to the intensive care unit, 34/41 (82.9%) required mechanical ventilation, and 17 (10.5%) of all hospitalized patients died. In total, 31 infections were diagnosed including five viral co-infections, 24 bacterial infections, and three fungal infections (ventilator-associated pneumonia, n = 5; tracheobronchitis, n = 13; pneumonia, n = 1; and bloodstream infection, n = 6). Median time to respiratory tract infection was 12.5 days (IQR, 8–18) and time to bloodstream infection 14 days (IQR, 6–30). Hospital-acquired bacterial and fungal infections were more frequent among ICU patients than other patients (36.6% vs. 1.7%). Antibiotic or antifungal treatment was administered in 71 (43.8%) patients. Conclusions Community-acquired viral and bacterial infections were rare among COVID-19 pneumonia patients. By contrast, hospital-acquired bacterial or fungal infections were frequently complicating the course among ICU patients. Supplementary Information The online version contains supplementary material available at 10.1186/s40560-021-00526-y.
【저자키워드】 COVID-19, SARS-CoV-2, Pneumonia, Sepsis, Bacterial secondary infections, 【초록키워드】 Hospitalized, intensive care, mechanical ventilation, Infection, respiratory tract infection, Infectious disease, diagnostics, acute lung injury, Antigen, infections, Secondary infection, Culture, male, Patient, Community, Complication, Bacterial infection, ICU Patients, molecular, information, Switzerland, Bacterial infections, patients, Blood, Bacterial, Frequency, Hospital-acquired infection, Fungal infection, Antifungal treatment, microbial, Ventilator-associated pneumonia, supplementary material, median age, bloodstream, University Hospital Basel, clinical evidence, COVID-19 pneumonia patients, Administered, objective, FIVE, ICU patient, Course, Result, died, diagnosed, evaluated, required, hospitalized patient, reached, excluded, declined, final cohort, IQR, patients hospitalized, patients with COVID-19, SARS-CoV-2-positive patient, 【제목키워드】 Infection, respiratory tract infection, bloodstream, patients hospitalized, with COVID-19,