Prevalence of respiratory bacterial infection in patients with COVID-19 and their antibacterial therapy recommendation

Ali Al-Fendi; Zahraa Ahmed Shakir; Wathiq Abbas Al-Draghi

Ali Al-Fendi university of baghdad
Zahraa Ahmed Shakir Lecturer, Department of Biotechnology Institute of Genetic Engineering and Biotechnology for Postgraduate Studies, Baghdad- Iraq
Wathiq Abbas Al-Draghi Professor, Department of Biotechnology Institute of Genetic Engineering and Biotechnology for Postgraduate Studies, Baghdad- Iraq

Keywords: COVID-19, Bacterial Co-infections, Antibiotic Resistance, Antibacterial Therapy, Antibiotic Stewardship

Abstract

Abstract

Background
Bacterial co-infections in COVID-19 patients can significantly influence outcomes and treatment strategies. However, the prevalence and antibiotic susceptibility patterns of these co-infections remain unclear, often leading to antibiotic overuse and antimicrobial resistance.

Objectives
this study aimed to assess the prevalence of respiratory bacterial infections in COVID-19 patients, identify common pathogens, evaluate antibacterial therapy practices, and provide evidence-based recommendations for managing co-infections.

Methods
A retrospective cohort study was conducted on 100 adult COVID-19 patients admitted to a tertiary care hospital. Demographic, clinical, microbiological, and antibiotic therapy data were collected. Standard respiratory sample culture techniques and antibiotic susceptibility testing were employed.

Results
Bacterial co-infections were identified in 30% of patients. The most common pathogens were Streptococcus pneumoniae (9 cases), Pseudomonas aeruginosa (9 cases), Haemophilus influenzae (8 cases), and Staphylococcus aureus (4 cases). Resistance patterns revealed high resistance to penicillin and macrolides in S. pneumoniae, carbapenem resistance in 33% of P. aeruginosa, and methicillin resistance in 50% of S. aureus. However, all isolates were sensitive to vancomycin and colistin.

Conclusion
The study highlights a high prevalence of bacterial co-infections and antibiotic resistance in COVID-19 patients, emphasizing the need for regular co-infection screening and antibiotic susceptibility testing. Implementing targeted antimicrobial therapy and antibiotic stewardship programs is critical to optimizing treatment and minimizing resistance.

How to cite this article:
Al-Fendi A M R M, Shakir Z A, Al-Draghi W A. Prevalence of Respiratory Bacterial Infection in Patients with COVID-19 and their Antibacterial Therapy Recommendation at a Hospital in Baghdad. J Commun Dis. 2025;57(2):102-114.

DOI: https://doi.org/10.24321/0019.5138.202544

References

Sieswerda E, De Boer MG, Bonten MM, Boersma WG, Jonkers RE, Aleva RM, Kullberg BJ, Schouten JA, van

de Garde EM, Verheij TJ, van der Eerden MM. Recommendations for antibacterial therapy in adults with COVID-19–an evidence based guideline. Clinical Microbiology and Infection. 2021 Jan 1;27(1):61-6. [Google Scholar] [Pubmed]

Vaughn VM, Gandhi TN, Petty LA, Patel PK, Prescott HC, Malani AN, Ratz D, McLaughlin E, Chopra V, Flanders

SA. Empiric antibacterial therapy and community-onset bacterial coinfection in patients hospitalized with

coronavirus disease 2019 (COVID-19): a multi-hospital cohort study. Clinical infectious diseases. 2021 May

;72(10):e533-41. [Google Scholar][Pubmed]