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Background The COVID-19 pandemic has raised concerns over secondary infections because it has limited treatment options and empiric antimicrobial treatment poses serious risks of aggravating antimicrobial resistance (AMR) Studies have shown that COVID-19 patients are predisposed to develop secondary infections This study was conducted to ascertain the prevalence and profiles of co- & secondary infections in patients at the COVID-19 facility in North India Methods We studied the profile of pathogens isolated from 290 clinical samples Bacterial and fungal pathogens were identified, and antimicrobial susceptibility was determined by the Vitek2® system Additionally, respiratory samples were tested for any viral/atypical bacterial co-infections and the presence of AMR genes by FilmArray test The clinical and outcome data of these patients were also recorded for demographic and outcome measures analyses Results A total of 151 (13%) patients had secondary infections, and most got infected within the first 14 days of hospital admission Patients aged >50 years developed severe symptoms (p = 0 0004) and/or had a fatal outcome (p = 0 0005) In-hospital mortality was 33% K pneumoniae (33 3%) was the predominant pathogen, followed by A baumannii (27 1%) The overall resistance was up to 84% Majority of the organisms were multidrug-resistant (MDR) harbouring MDR genes Conclusion A high rate of secondary infections with resistant pathogens in COVID-19 patients highlights the importance of antimicrobial stewardship programs focussing on supporting the optimal selection of empiric treatment and rapid-de-escalation, based on culture reports
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Indian_Journal_of_Medical_Microbiology
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Profile of co-infections &secondary infections in COVID-19 patients at a dedicated COVID-19 facility of a tertiary care Indian hospital: Implication on antimicrobial resistance
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