PROFILE OF HEALTHCARE-ASSOCIATED INFECTIONS (HAIs) BY ACINETOBACTER BAUMANNII IN COVID-19 PATIENTS

Abstract

Coinfection with bacterial pathogens in viral respiratory infections such as COVID-19 is an important cause of morbidity and mortality. The excessive use of antibiotics during the COVID-19 pandemic and the increased incidence of microbial resistance, especially of Acinetobacter baumannii (A. baumannii) are an important public health concern, as it is an important nosocomial pathogen. Therefore, the objective of this study was to describe the profile of A. baumannii infections in patients hospitalized during the COVID-19 pandemic and to determine the risk factors associated with co-infection. Therefore, it was carried out a descriptive study of literature review in the PubMed and Scielo databases using "COVID-19", "Acinetobacter baumannii" and "antimicrobial resistance" as descriptors. The data obtained showed that coinfections and secondary infections in patients with SARS-CoV-2 ranged from 0.6 to 45%. There was a higher prevalence of infections by gram-negative bacteria, especially A. baumannii and Klebsiella pneumoniae, with A. baumannii isolates showing reduced susceptibility to the most antibiotics tested and polymyxin as the most active agent. There was an increase of about 23% in infections by multidrug resistant microorganisms (MDR), with a significant increase of 108% for carbapenem-resistant A. baumannii (CRAB). Outbreaks associated with CRAB producers of OXA-23 and ArmA were identified as responsible by the inter-hospitalar dissemination of this pathogen. Male patients, aged over 60 years, diabetic and obese were predominant in ICU admissions and CRAB co-infection in COVID-19 patients in ICU were responsible for the increase in 30-day mortality.

Keywords: Coinfection, Acinetobacter baumanni, COVID-19, Multidrug Resistance