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Critical priority Multidrug-Resistant Organisms (MDROs) secondary infection among COVID-19 patients: hidden threat during a pandemic? A retrospective study

  • Irbasmantini Syaiful ,
  • Ni Made Mertaniasih ,
  • Lindawati Alimsardjono ,
  • Pepy Dwi Endraswari ,
  • Arie Utariani ,
  • Budi Utomo ,


Abstract

Background: The global Coronavirus Disease 2019 (COVID-19) pandemic is superimposed on the ongoing Multidrug-Resistant Organisms (MDROs) pandemic. Bacterial co-infection, particularly those caused by MDROs, is one of the risk factors linked to higher morbidity and mortality rates in COVID-19 patients. This study aims to compare critical priority MDROs profile causing bacteremia in COVID-19 and non-COVID-19 patients during a pandemic.

Methods: A hospital-based retrospective cross-sectional study was conducted at Dr. Soetomo General Academic Hospital from April 2020 to December 2021. This study used a consecutive sampling technique, which included and analyzed all identified microorganism isolates from blood specimens that met the inclusion criteria. The Mann-Whitney test was used to compare MDRO profiles between COVID-19 and non-COVID-19 patients, which is significant if p < 0.05.

Results: The total proportion of critical priority MDRO isolates in COVID-19 patients was 90/390 (23.08%), while in non-COVID-19 patients were 377/1446 (26.07%) isolates (p=0.228). Carbapenem-resistant Acinetobacter baumannii (CRAB) had a higher proportion of events in COVID-19 patients (12.05% vs. 7.05%, p < 0.001). In contrast, extended-spectrum β-lactamases (ESBL)-producing Klebsiella pneumoniae (ESBL-KP) had a higher proportion of events in non-COVID patients (7.54% vs. 2.82%, p < 0.001). Acinetobacter baumannii exhibited a high level of resistance, with 149/223 (66.82%) of the isolates being CRAB, with the COVID-19 group accounting for 47/59 (79.66%) and the non-COVID-19 group accounting for 102/164 (62.19%; z = 2.438; p = 0.015).

Conclusion: The high proportion and resistance rate of critical priority MDROs, CRAB particularly, among COVID-19 patients, highlights the importance of effective AMR control practices and prevention strategies during the pandemic.

Keywords: Bacteremia COVID-19 CRAB critical priority MDROs

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How to Cite

Syaiful, I., Mertaniasih, N. M., Alimsardjono, L., Endraswari, P. D., Utariani, A., & Utomo, B. (2023). Critical priority Multidrug-Resistant Organisms (MDROs) secondary infection among COVID-19 patients: hidden threat during a pandemic? A retrospective study . Bali Medical Journal, 12(1), 416–422. https://doi.org/10.15562/bmj.v12i1.3950
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Irbasmantini Syaiful
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Ni Made Mertaniasih
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Lindawati Alimsardjono
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Pepy Dwi Endraswari
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Arie Utariani
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Budi Utomo
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