Increased incidence of urinary tract infections caused by Enterococcus in COVID-19 patients of the Clinical Center of Vojvodina

  • Gordana Smieško 1- Katedra za mikrobiologiju sa parazitologijom i imunologijom, Medicinski fakultet Novi Sad, Univerzitet u Novom Sadu, 21000 Novi Sad
  • Marija Baroš Brkljača Institut za javno zdravlje Vojvodine, 21000 Novi Sad
  • Pavle Z Banović 1.Pasterov zavod Novi Sad 2.Medicinski fakultet Novi Sad, Univerzitet u Novom Sadu
DOI: https://doi.org/10.5937/pomc19-37033
Keywords: urine, COVID19, Vojvodina, Enterococcus, Escherichia coli

Abstract


Objective: To investigate the frequency of isolates of various uropathogens in patients of COVID19 Hospital "Mišeluk" in comparison with patients from the non-COVID19 zone of the Clinical Center of Vojvodina (KCV).

Methods: For the purpose of this study, information was collected on urine isolates sent from COVID19 hospital and non-COVID19 zones of the Clinical Center of Vojvodina in a three-month period, with samples from non-COVID19 zone KCV served as controls.

Results: Of the 449 patients from COVID19 Hospital, the most common causative agents of intrahospital urinary infection (IUI) were members of the genus Enterococcus, (216/449; 48.10%), who in most cases caused IUI in women (127/216; 58.79%). The second most common causative agent of IUT in COVID19 is Klebsiella pneumoniae (85/449; 18.93%). Of the 913 patients from the non-COVID19 KCV clinic, the most common cause of IUI was Escherichia coli (249/913; 27.27%), predominantly in women (199/249; 79.91%, (χ2 (1) = 49,042). p <0.00001)). The second most frequent causative IUTs are members of the genus Enterococcus, (216/913; 23.65%), with no significant difference in distribution between the sexes (χ2 (1) = 0.0833; p = 0.847).

Conclusion: The most common causes of IUI in COVID19 KCV hospital are members of the genera Enterococcus and Klebsiella pneumoniae with almost equal distribution between the sexes. There was a statistically significant difference in the frequency of different IUI agents in COVID19 hospital patients versus non-COVID19 KCV clinic. These results may be important in determining empirical therapy in patients with COVID19 KCV Hospital, as well as in planning procedures for the reduction of nosocomial infections.

References


  1. Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015 May;13(5):269–84.

  2. Woldemariam HK, Geleta DA, Tulu KD, Aber NA, Legese MH, Fenta GM, et al. Common uropathogens and their antibiotic susceptibility pattern among diabetic patients. BMC Infect Dis. 2019 Jan 10;19(1):43.

  3. Stefaniuk E, Suchocka U, Bosacka K, Hryniewicz W. Etiology and antibiotic susceptibility of bacterial pathogens responsible for community-acquired urinary tract infections in Poland. Eur J Clin Microbiol Infect Dis Off Publ Eur Soc Clin Microbiol. 2016 Aug;35(8):1363–9.

  4. Rizwan M, Akhtar M, Najmi AK, Singh K. Escherichia coli and Klebsiella pneumoniae Sensitivity/Resistance Pattern Towards Antimicrobial Agents in Primary and Simple Urinary Tract Infection Patients Visiting University Hospital of Jamia Hamdard New Delhi. Drug Res. 2018 Jul;68(7):415–20.

  5. Behzadi P, Behzadi E, Yazdanbod H, Aghapour R, Akbari Cheshmeh M, Salehian Omran D. A survey on urinary tract infections associated with the three most common uropathogenic bacteria. Maedica. 2010 Apr;5(2):111–5.

  6. Gupta K, Hooton TM, Naber KG, Wullt B, Colgan R, Miller LG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis Off Publ Infect Dis Soc Am. 2011 Mar 1;52(5):e103-120.

  7. Karaba SM, Jones G, Helsel T, Smith LL, Avery R, Dzintars K, et al. Prevalence of Co-infection at the Time of Hospital Admission in COVID-19 Patients, A Multicenter Study. Open Forum Infect Dis. 2021 Jan;8(1):ofaa578.

  8. Garcia-Vidal C, Sanjuan G, Moreno-García E, Puerta-Alcalde P, Garcia-Pouton N, Chumbita M, et al. Incidence of co-infections and superinfections in hospitalized patients with COVID-19: a retrospective cohort study. Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis. 2021 Jan;27(1):83–8.

  9. Bardi T, Pintado V, Gomez-Rojo M, Escudero-Sanchez R, Azzam Lopez A, Diez-Remesal Y, et al. Nosocomial infections associated to COVID-19 in the intensive care unit: clinical characteristics and outcome. Eur J Clin Microbiol Infect Dis Off Publ Eur Soc Clin Microbiol. 2021 Mar;40(3):495–502.

  10. Zuglian G, Ripamonti D, Tebaldi A, Cuntrò M, Riva I, Farina C, et al. The changing pattern of bacterial and fungal respiratory isolates in patients with and without COVID-19 admitted to intensive care unit. BMC Infect Dis. 2022 Feb 23;22(1):185.

  11. DeVoe C, Segal MR, Wang L, Stanley K, Madera S, Fan J, et al. Increased rates of secondary bacterial infections, including Enterococcus bacteremia, in patients hospitalized with coronavirus disease 2019 (COVID-19). Infect Control Hosp Epidemiol. 2021 Sep 6;1–8.


 

Published
2023/02/11
Issue
Vol. 19 No. 1 (2022): PONS MEDICINSKI CASOPIS
Section
Original Scientific Paper