Prevalence and Antimicrobial Resistance of Bacteria Isolated from Clinical Specimens of COVID-19 Patients Admitted to Fatemeh Zahra Hospital in Sari, Iran
نویسندگان
1 4Department of Laboratory Sciences, School of Allied Medical Sciences, Sari, Iran
2 5Department of Molecular Genetics, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran
3 6Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
4 7Department of Microbiology, Faculty of Advanced Sciences, Islamic Azad University, Tehran, Iran
5 4Department of Laboratory Sciences, School of Allied Medical Sciences, Sari, Iran
6 1Faculty of Paramedical Sciences, Mazandaran University of Medical Sciences, Sari, Iran, 9Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
7 2Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
8 3Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
9 3Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
10 8Fatemeh Zahra Hospital, Mazandaran University of Medical Sciences, Sari, Iran
11 1. Faculty of Paramedical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
doi
10.22037/nbm.v14i2.51098چکیده
Background: The COVID-19 pandemic has heightened concerns over secondary bacterial infections, which worsen outcomes in hospitalized patients. This study investigated the prevalence and antibiotic resistance of bacteria isolated from clinical specimens of COVID-19 patients admitted to Fatemeh Zahra Hospital in Sari, Iran. Materials and Methods: From September 2020 to August 2022, 3314 COVID-19 patients were included, with 55 positive cultures (including bacterial and fungal) obtained from 47 patients. The most common sources were urine (52.7%) and respiratory samples (38.1%). Gram-negative bacteria (58.9%), primarily Enterobacteriaceae (84.8%), were predominant, followed by Pseudomonas spp. and Acinetobacter. Gram-positive isolates included Staphylococcus aureus and coagulase-negative staphylococci. ICU-admitted patients showed higher co-infection rates, with increased mortality linked to bacterial infections. Antimicrobial susceptibility testing revealed concerning resistance patterns, including high resistance to ceftazidime (85% in Gram-negatives), imipenem (45% in Acinetobacter), and amikacin (50% in Pseudomonas), underscoring the challenge posed by multidrug-resistant organisms (MDROs). Among Gram-negative isolates, 30% were extensively drug-resistant (XDR). Results: Despite a low overall co-infection rate (1.3%), bacterial infections significantly impacted disease severity and mortality. The findings align with regional studies highlighting Gram-negative pathogens as major contributors. Compared with pre-pandemic reports from Iran, resistance rates to carbapenems increased from ~43% to 65% among Acinetobacter baumannii. The rise in antimicrobial resistance (AMR) underscores the need for strict antibiotic stewardship and robust infection control measures. Conclusion: This study emphasizes the critical role of bacterial co-infections in COVID-19 outcomes and calls for continuous surveillance to guide effective treatment strategies during the pandemic.
