Staphylococcus aureus bacteremia in patients with SARS-CoV-2 infection

The study titled “Staphylococcus aureus bacteremia in patients with SARS-CoV-2 infection” by Iker Falces-Romero and colleagues offers significant insights into the prevalence and characteristics of Staphylococcus aureus (S. aureus) bacteremia in COVID-19 patients compared to non-COVID-19 patients during the pandemic​​.

Key Findings of the Study:

  1. Objectives and Methods: The study aimed to compare the incidence of S. aureus bacteremia in COVID-19 and non-COVID-19 adult patients during the pandemic versus the previous two years. It was a retrospective study conducted at a tertiary-care center, analyzing clinical records and the Microbiology Department database​​.
  2. Increased Incidence in COVID-19 Patients: The incidence of S. aureus bacteremia was significantly higher in COVID-19 patients (10.59 episodes per 1000 admissions) compared to non-COVID-19 patients (1.96 episodes per 1000 admissions) during the pandemic. This marked increase was contrasted with the incidence rates of 1.95 and 1.63 per 1000 admissions in 2018 and 2019, respectively​​.
  3. Methicillin Resistance and Mortality Rates: Methicillin-resistant Staphylococcus aureus (MRSA) was found in 32.4% of isolates from COVID-19 patients, a higher rate compared to 13.8% in non-COVID-19 patients. Notably, mortality rates were significantly higher in COVID-19 patients, both in terms of 15-day and 30-day mortality​​.
  4. Sources of Infection: The primary source of bacteremia in COVID-19 patients was pulmonary, likely related to direct lung damage caused by the virus. In contrast, non-COVID-19 patients primarily had endovascular sources of bacteremia​​.
  5. Role of COVID-19 Treatments and Management: The study suggests that the sequence of infection leading to S. aureus bacteremia in COVID-19 might be partly attributable to the treatments and management of COVID-19, such as the use of central venous catheters, intubation, and corticosteroids, which are direct risk factors for developing nosocomial bacteremia​​.
  6. Implications for COVID-19 Management: The study underscores the importance of understanding the relationship between secondary bacteremia due to S. aureus, including MRSA, in COVID-19 patients and their outcomes. It highlights the need for further investigation to clarify this relationship​​

This study highlights the increased risk and severity of S. aureus bacteremia in COVID-19 patients, emphasizing the importance of vigilant monitoring and management of secondary bacterial infections in these patients. The findings also underscore the complexities involved in treating COVID-19, including the potential for increased bacterial infections and associated mortality rates.

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