Abstract

Abstract Background To explore and describe the current literature surrounding bacterial/fungal coinfection in patients with coronavirus infection. Methods MEDLINE, EMBASE, and Web of Science were searched using broad-based search criteria relating to coronavirus and bacterial coinfection. Articles presenting clinical data for patients with coronavirus infection (defined as SARS-1, MERS, SARS-CoV-2, and other coronavirus) and bacterial/fungal coinfection reported in English, Mandarin, or Italian were included. Data describing bacterial/fungal coinfections, treatments, and outcomes were extracted. Secondary analysis of studies reporting antimicrobial prescribing in SARS-CoV-2 even in absence of coinfection was performed. Results 1007 abstracts were identified. Eighteen full texts reporting bacterial/fungal coinfection were included. Most studies did not identify or report bacterial/fungal coinfection (85/140; 61%). Nine of 18 (50%) studies reported on COVID-19, 5/18 (28%) on SARS-1, 1/18 (6%) on MERS, and 3/18 (17%) on other coronaviruses. For COVID-19, 62/806 (8%) patients were reported as experiencing bacterial/fungal coinfection during hospital admission. Secondary analysis demonstrated wide use of broad-spectrum antibacterials, despite a paucity of evidence for bacterial coinfection. On secondary analysis, 1450/2010 (72%) of patients reported received antimicrobial therapy. No antimicrobial stewardship interventions were described. For non–COVID-19 cases, bacterial/fungal coinfection was reported in 89/815 (11%) of patients. Broad-spectrum antibiotic use was reported. Conclusions Despite frequent prescription of broad-spectrum empirical antimicrobials in patients with coronavirus-associated respiratory infections, there is a paucity of data to support the association with respiratory bacterial/fungal coinfection. Generation of prospective evidence to support development of antimicrobial policy and appropriate stewardship interventions specific for the COVID-19 pandemic is urgently required.

Keywords

CoinfectionMedicineAntimicrobialAntimicrobial stewardshipCoronavirusIntensive care medicineMicrobiologyImmunologyCoronavirus disease 2019 (COVID-19)AntibioticsInternal medicineAntibiotic resistanceBiologyHuman immunodeficiency virus (HIV)Infectious disease (medical specialty)Disease

MeSH Terms

Anti-Infective AgentsAntimicrobial StewardshipBacterial InfectionsCOVID-19CoinfectionDrug ResistanceMicrobialHumansMycosesSARS-CoV-2COVID-19 Drug Treatment

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Publication Info

Year
2020
Type
review
Volume
71
Issue
9
Pages
2459-2468
Citations
1644
Access
Closed

External Links

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1644
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57
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877
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Cite This

Timothy M. Rawson, Luke Moore, Nina Zhu et al. (2020). Bacterial and Fungal Coinfection in Individuals With Coronavirus: A Rapid Review To Support COVID-19 Antimicrobial Prescribing. Clinical Infectious Diseases , 71 (9) , 2459-2468. https://doi.org/10.1093/cid/ciaa530

Identifiers

DOI
10.1093/cid/ciaa530
PMID
32358954
PMCID
PMC7197596

Data Quality

Data completeness: 90%