Post by Nadica (She/Her) on Dec 6, 2024 3:53:41 GMT
Higher risk of accompanying bacterial infections with flu, RSV than SARS-CoV-2 - Published Dec 5, 2024
A population-based study in Ontario found a higher prevalence and risk of concomitant bacterial infection in patients infected with influenza and respiratory syncytial virus (RSV) compared with SARS-CoV-2, researchers reported this week in Open Forum Infectious Diseases.
But the risk of bacterial infections in COVID-19 patients was substantially elevated after 48 hours compared with the other viruses.
Using datasets from Ontario Laboratories Information System, a team led by researchers from the Institute for Clinical Evaluative Sciences in Toronto investigated the prevalence of concomitant bacterial infections in patients with lab-confirmed influenza A and B (FLUA and FLUB) and RSV from 2017 through 2019 and SARS-CoV-2 from 2020 through 2021. They also examined whether risk factors, such as patient characteristics, are associated with differential risks of concomitant bacterial infection. Concomitant infections were classified into coinfection (–2 to +2 days from viral infection) and secondary infection (more than 2 days after viral infection).
Among the 885,004 respiratory viral infections observed during the study period, 4,230 (0.5%) were associated with concomitant bacterial infections, which were found in 422 of 8,891 (4.7%) FLUB patients, 861 of 22,313 (3.9%) FLUA patients, 428 of 12,744 (3.4%) RSV patients, and 2,519 of 841,026 (0.3%) COVID-19 patients. The most prevalent species causing concomitant bacterial infection were Staphylococcus aureus,Streptococcus pyogenes, and Pseudomonas aeruginosa.
Higher risk of secondary infection with SARS-CoV-2
After adjusting for covariates, the odds ratio for bacterial infection was 1.69 (95% Confidence Interval (CI), 1.48 to 1.93) for FLUA, 2.30 (95%CI, 1.97 to 2.69) for FLUB, and 1.56 (95%CI, 1.33 to 1.82) for RSV compared with SARS-CoV-2. Stratified analysis revealed that while the adjusted odds of bacterial co-infection were lower for SARS-CoV-2, odds of secondary bacterial infection with SARS-CoV-2 were higher than FLUA, FLUB, and RSV.
The study authors say the findings have important implications for antimicrobial stewardship.
"Antimicrobial prescribing is common in patients with COVID-19 which can adversely impact antimicrobial resistance," they wrote. "However, early empiric prescribing in non-critically ill patients is not justified given the relatively low risk of co-infection. Such findings should be considered to support judicious prescribing decisions in patients with suspected or proven COVID-19."
Study Link: academic.oup.com/ofid/advance-article/doi/10.1093/ofid/ofae701/7915944
A population-based study in Ontario found a higher prevalence and risk of concomitant bacterial infection in patients infected with influenza and respiratory syncytial virus (RSV) compared with SARS-CoV-2, researchers reported this week in Open Forum Infectious Diseases.
But the risk of bacterial infections in COVID-19 patients was substantially elevated after 48 hours compared with the other viruses.
Using datasets from Ontario Laboratories Information System, a team led by researchers from the Institute for Clinical Evaluative Sciences in Toronto investigated the prevalence of concomitant bacterial infections in patients with lab-confirmed influenza A and B (FLUA and FLUB) and RSV from 2017 through 2019 and SARS-CoV-2 from 2020 through 2021. They also examined whether risk factors, such as patient characteristics, are associated with differential risks of concomitant bacterial infection. Concomitant infections were classified into coinfection (–2 to +2 days from viral infection) and secondary infection (more than 2 days after viral infection).
Among the 885,004 respiratory viral infections observed during the study period, 4,230 (0.5%) were associated with concomitant bacterial infections, which were found in 422 of 8,891 (4.7%) FLUB patients, 861 of 22,313 (3.9%) FLUA patients, 428 of 12,744 (3.4%) RSV patients, and 2,519 of 841,026 (0.3%) COVID-19 patients. The most prevalent species causing concomitant bacterial infection were Staphylococcus aureus,Streptococcus pyogenes, and Pseudomonas aeruginosa.
Higher risk of secondary infection with SARS-CoV-2
After adjusting for covariates, the odds ratio for bacterial infection was 1.69 (95% Confidence Interval (CI), 1.48 to 1.93) for FLUA, 2.30 (95%CI, 1.97 to 2.69) for FLUB, and 1.56 (95%CI, 1.33 to 1.82) for RSV compared with SARS-CoV-2. Stratified analysis revealed that while the adjusted odds of bacterial co-infection were lower for SARS-CoV-2, odds of secondary bacterial infection with SARS-CoV-2 were higher than FLUA, FLUB, and RSV.
The study authors say the findings have important implications for antimicrobial stewardship.
"Antimicrobial prescribing is common in patients with COVID-19 which can adversely impact antimicrobial resistance," they wrote. "However, early empiric prescribing in non-critically ill patients is not justified given the relatively low risk of co-infection. Such findings should be considered to support judicious prescribing decisions in patients with suspected or proven COVID-19."
Study Link: academic.oup.com/ofid/advance-article/doi/10.1093/ofid/ofae701/7915944