Abstract

Bacterial and fungal infections in COVID-19 patients were reported all over the world. A retrospective study was conducted to determine the prevalence of bacterial and fungal superinfections in COVID-19 positive patients between April 2020 and December 2021. This research included patients admitted in a specialized medical center in Saudi Arabia. A total of 2643 patients with confirmed diagnosis of COVID-19 via reverse transcriptase-polymerase chain reaction assay (RT-PCR) conducted on nasopharyngeal swab and chest computed tomography. The age forty-nine years (SD 12·5) 2087 were men (79%). Patients with positive cultures for bacteria or fungi were included in the study, and patients with negative cultures were excluded. Total number of COVID-19 patients who acquired bacterial infection was 509 (19%) and two hundred forty-six (246) of COVID-19 patients were admitted to ICU and were under mechanical ventilation (9.3%). All mechanically ventilated cases developed bacterial ventilator associated pneumonia. Multidrug resistant organisms represent 97%. Extended spectrum b-lactamase comprise 35.1%, Methicillin resistant Staph aureus 32.2%, vancomycin resistant Enterococci 2.1%. Clostridium difficile was 1.7%. 46 patients under mechanical ventilation acquired fungal superinfection (18.6%) with long duration of mechanical ventilation more than 14 days (p value=0.019) and under dexamethasone treatment (p value=0.027). Candida is the most common type of fungi isolated (89%). Candida auris isolated from three cases (6.5%), one case developed invasive mucormycosis (2%) one acquired invasive Aspergillosis (2%). 5 patients died (11%). This research tries to provide factual evidence of types of bacterial and fungal superinfection in COVID-19 cases and implement prevention and control measures of infection.

Key words: Bacteria, fungal, COVID-19, infections, PCR.