COVID-19 Superinfections and Antimicrobial Resistance

Epidemiologic, clinical, microbiologic and antimicrobial resistance (AMR) data on nosocomial superinfections during the coronavirus disease 2019 (COVID-19) pandemic is needed to inform stewardship that will be crucial for limiting broad-spectrum antimicrobial use in hospitalized patients, according to a review published in Clinical Infectious Diseases.

According to the review authors, limited data from case series indicate that it will be reasonable to anticipate that, “an appreciable minority of patients with severe COVID-19 will develop superinfections, most commonly pneumonia due to nosocomial bacteria and Aspergillus.” Therefore, widespread, broad-spectrum antimicrobial use will likely occur among hospitalized patients. In fact, through mid-February 2020, secondary infections were reported in a range of 5% to 27% of adults with COVID-19 in several hospitals in Wuhan, China, and among 13.5% to 44% of patients in the intensive care unit. Moreover, the review authors highlighted that previous literature with data from from 552 hospitals in 30 Chinese provinces, show that 58% of patients were treated with antibiotics.