Prevalence of Aspergillus and extremely resistant bacterial superinfection among sever Covid-19 patients

Authors

  • Safeen Othman Mahmood MBChB. FKBMS Clinical Microbiology, Branch of Basic Sciences, College of Medicine, University of Sulaimani, Sulaimani, Iraq,

DOI:

https://doi.org/10.56056/

Keywords:

Aspergillus, Co-infection acute respiratory distress syndrome, Invasive pulmonary aspergillosis

Abstract

Background and objectives: Co-infections involving bacteria or viruses alongside severe acute respiratory syndrome coronavirus-2 have been documented in numerous studies. The understanding of Aspergillus coinfection in individuals suffering from coronavirus disease 2019 was found to be constrained. This study aims to explore the updated information about coronavirus 2019 associated with pulmonary aspergillosis.

Methods: This study was conducted at coronavirus disease-19 hospital and intensive care unit of Sulaimani and San private clinic and laboratories, from jan-2021 to feb-2022. Seventy-five patients were enrolled, including patients who were intubated on a mechanical ventilator and continuous positive airway pressure mask treatment. The intubated patients were screened after 2-3 days. Non-intubated patients on continuous positive airway pressure mask; sputum study was performed if evidence of secondary chest infection was present including rising fever, and productive cough, with laboratory markers and radiologic investigation.

Results: Out of 75 patients, 10.7% (n=8) were culture negative, 89.3% (n=67) were secondary microbial infection, 64.0% (n=48) were bacterial infection, 25.3% (n=19) were Aspergillus Species, having invasive pulmonary mold superinfection. The majority (42.1%, n=8) noticed in those aged between 60-70 years. Aspergillus flavus was the dominant mold (52.6%, n=10). 63.2% (n=12) of the Aspergillus infection was recorded in those patients who were treated with steroids for 11-20 days, with significant difference (P<0.001).

Conclusion: Increasing age, comorbidity like diabetes and extended course of corticosteroid were linked to a higher incidence of invasive pulmonary aspergillosis. Extremely resistant Acinetobacter and E. coli superinfection were estimated as the most common bacterial element in sever coronavirus-2019 pneumonias.

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References

1.Chauhan S. Comprehensive review of coronavirus disease 2019 (COVID-19). Biomed J. 2020;43(4):334-40.

2.Sharma A, Tiwari S, Deb MK, Marty JL. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2): a global pandemic and treatment strategies. Int J Antimicrob Agents. 2020;56(2):106054.

3.Zhang Y, Geng X, Tan Y, Li Q, Xu C, Xu J, et al. new understanding of the damage of SARS-CoV-2 infection outside the respiratory system. Biomed Pharmacother. 2020 Jul: 127:110195. doi: 10.1016/j.biopha.2020.110195/

4.Maes M, Higginson E, Pereira-Dias J, Curran MD, Parmar S, Khokhar F, et al. Ventilator-associated pneumonia in critically ill patients with COVID-19. Crit Care. 2021; 25:1-11.

5.Zijie S, Yan X, Lu K, Wentai M, Leisheng S, Li Z, et al. Genomic diversity of SARS-CoV-2 in Coronavirus Disease 2019 patients. Clin Infect Dis. 2020;9.

6.Tay MZ, Poh CM, Rénia L, MacAry PA, Ng LF. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol. 2020;20(6):363-74.

7.Cataño-Correa JC, Cardona-Arias JA, Porras Mancilla JP, García MT. Bacterial superinfection in adults with COVID-19 hospitalized in two clinics in Medellín-Colombia, 2020. PloS one. 2021;16(7): e0254671.

8.Singh V, Upadhyay P, Reddy J, Granger J. SARS-CoV-2 respiratory co-infections: Incidence of viral and bacterial co-pathogens. Int J Infect Dis. 2021; 105:617-20.

9.Rangel K, Chagas TPG, De-Simone SG. Acinetobacter baumannii infections in times of COVID-19 pandemic. Pathogens. 2021;10(8):1006.

10.Kakamad FH, Mahmood SO, Rahim HM, Abdulla BA, Abdullah HO, Othman S, et al. Post covid-19 invasive pulmonary Aspergillosis: a case report. nt J Surg Case Rep. 2021; 82:105865.

11.Fekkar A, Lampros A, Mayaux J, Poignon C, Demeret S, Constantin JM, et al. Occurrence of invasive pulmonary fungal infections in patients with severe COVID-19 admitted to the ICU. Am J Respir Crit Care Med. 2021;203(3):307-17.

12.Lai CC, Yu WL. COVID-19 associated with pulmonary aspergillosis: A literature review

J Microbiol Immunol Infect. 2021 Feb;54(1):46-53. doi: 10.1016/j.jmii.2020.09.004. Epub 2020 Sep 24.

13.Ogawa Y, Murata K, Hasegawa K, Nishida K, Gohma I, Kasahara K. Clinical characteristics of patients with coronavirus disease 2019–associated pulmonary aspergillosis on mechanical ventilation: A single-center retrospective study in Japan. J Infect Chemother. 2023 Mar; 29(3): 239–243.

14.Chen X, Liao B, Cheng L, Peng X, Xu X, Li Y, et al. The microbial coinfection in COVID-19. Appl Microbiol Biotechnol. 2020; 104:7777-85.

15.Guinea J, Torres-Narbona M, Gijon P, Muñoz P, Pozo F, Peláez T, et al. Pulmonary aspergillosis in patients with chronic obstructive pulmonary disease: incidence, risk factors, and outcome. Clin Microbiol Infect. 2010 Jul;16(7):870-7. doi: 10.1111/j.1469-0691.2009.03015. x. Epub 2009 Nov 10.

16.Gaffney S, Kelly DM, Rameli PM, Kelleher E, Martin?Loeches I. Invasive pulmonary aspergillosis in the intensive care unit: current challenges and best practices. APMIS. 2023;131(11):654-67.

17.CDC A. Guidelines for prevention of nosocomial pneumonia. MMWR Recomm Rep. 1997 Jan 3;46(RR-1):1-79.

18.Cahill CK, Heath J. Sterile water used for humidification in low-flow oxygen therapy: is it necessary Am J Infect Control. 1990;18(1):13-7.

19.Avasthi RD, Jain G, Sharma SK. Is Oxygen Humidification with Sterile Water Essential to Prevent Risk of Infection? Indian j. respir. care. 2022:200.

20.Wenzel M, Klauke M, Gessenhardt F, Dellweg D, Haidl P, Schönhofer B, et al. Sterile water is unnecessary in a continuous positive airway pressure convection-type humidifier in the treatment of obstructive sleep apnea syndrome. Chest. 2005;128(4):2138-40.

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Published

2026-03-01

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How to Cite

Prevalence of Aspergillus and extremely resistant bacterial superinfection among sever Covid-19 patients. (2026). AMJ (Advanced Medical Journal) , 11(1), 207-215. https://doi.org/10.56056/