Publication: Co-infection of Uropathogenic Escherichia coli among COVID-19 Patients Admitted to a Tertiary Care Centre: A Descriptive Cross-sectional Study
Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
Nepal Medical Association
Abstract
Abstract:
Introduction: Simultaneous infection of antibiotic-resistant uropathogens in patients with COVID-19 has necessitated the revision of the prescription of broad-spectrum antibiotics on the grounds of evidence-based studies and antimicrobial stewardship principles. The objective of this study was to find out the prevalence of uropathogenic Escherichia coli co-infection among hospital-admitted COVID-19 patients of a tertiary care centre.
Methods: This descriptive cross-sectional study was conducted in urinary tract infection suspected COVID-19 patients admitted to a tertiary care hospital, from 25th June to 24th December 2021 after ethical clearance from the Institutional Review Committee with registration number 207707860. Convenience sampling was used. Serum procalcitonin levels were also measured. Data analysis was performed using the Statistical Package for the Social Sciences software version 17.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data, and mean and standard deviation for continuous data.
Results: Among the 49 hospital-admitted COVID-19 patients, 3 (6.12%) (0.59-12.83 at 95% Confidence Interval) were co-infected with uropathogenic Escherichia coli. Absolute non-susceptibility of Escherichia coli to antibiotics such as ceftriaxone, cotrimoxazole, nalidixic acid, gentamicin, and ampicillin was observed. All isolates were multidrug-resistant. All co-infected patients were female and had a median age of 35 years. Mean±SD value for procalcitonin in patients with co-infection (6.13±7.88 ng/ml) was six times higher than for the patients without co-infection (0.95±1.11 ng/ml).
Conclusions: Escherichia coli co-infection in hospitalised COVID-19 patients was less frequent as compared to published literature. The serum procalcitonin value in patients with co-infection was substantially higher than that of patients without co-infection.
Description
Ajaya Basnet
Department of Medical Microbiology, Shi-Gan International College of Science and Technology, Tribhuvan University, Kathmandu, Nepal
https://orcid.org/0000-0003-4991-6389
Arun Bahadur Chand
Department of Clinical Laboratory, KIST Medical College and Teaching Hospital, Lalitpur, Nepal
https://orcid.org/0000-0002-3021-2886
Lok Bahadur Shrestha
School of Medical Sciences and the Kirby Institute, University of New South Wales, Sydney, Australia
https://orcid.org/0000-0002-0054-0715
Nayanum Pokhrel
Nepal Health Research Council, Kathmandu, Nepal
https://orcid.org/0000-0001-6938-6034
Lochan Karki
Department of Medicine, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
Sailendra Kumar Duwal Shrestha
Department of Orthopaedic and Trauma Services, Nepal Armed Police Force Hospital, Kathmandu, Bagmati, Nepal
Basanta Tamang
Department of Clinical Laboratory, Nepal Armed Police Force Hospital, Kathmandu, Nepal
https://orcid.org/0000-0003-3082-9760
Mahendra Raj Shrestha
Department of Clinical Laboratory, Nepal Armed Police Force Hospital, Kathmandu, Nepal
https://orcid.org/0000-0002-8292-5757
Maina Dulal
Department of Medical Microbiology, Shi-Gan International College of Science and Technology, Tribhuvan University, Kathmandu, Nepal
https://orcid.org/0000-0002-2600-8794
Junu Richhinbung Rai
Department of Clinical Microbiology, Tribhuvan University Teaching Hospital, Kathmandu, Bagmati, Nepal.
https://orcid.org/0000-0002-4737-2130
Keywords
antimicrobial drug resistance, co-infection, COVID-19, Escherichia coli, procalcitonin.