Bacterial coinfection and antibiotic resistance in hospitalized COVID-19 patients: a systematic review and meta-analysis.

Abstract

<h4>Background</h4>There were a few studies on bacterial coinfection in hospitalized COVID-19 patients worldwide. This systematic review aimed to provide the pooled prevalence of bacterial coinfection from published studies from 2020 to 2022.<h4>Methods</h4>Three databases were used to search the studies, and 49 studies from 2,451 identified studies involving 212,605 COVID-19 patients were included in this review.<h4>Results</h4>The random-effects inverse-variance model determined that the pooled prevalence of bacterial coinfection in hospitalized COVID-19 patients was 26.84% (95% CI [23.85-29.83]). The pooled prevalence of isolated bacteria for <i>Acinetobacter baumannii</i> was 23.25% (95% CI [19.27-27.24]), <i>Escherichia coli</i> was 10.51% (95% CI [8.90-12.12]), <i>Klebsiella pneumoniae</i> was 15.24% (95% CI [7.84-22.64]), <i>Pseudomonas aeruginosa</i> was 11.09% (95% CI [8.92-13.27]) and <i>Staphylococcus aureus</i> (11.59% (95% CI [9.71-13.46])). Meanwhile, the pooled prevalence of antibiotic-resistant bacteria for extended-spectrum beta-lactamases producing Enterobacteriaceae was 15.24% (95% CI [7.84-22.64]) followed by carbapenem-resistant <i>Acinetobacter baumannii</i> (14.55% (95% CI [9.59-19.52%])), carbapenem-resistant <i>Pseudomonas aeruginosa</i> (6.95% (95% CI [2.61-11.29])), methicillin-resistant <i>Staphylococcus aureus</i> (5.05% (95% CI [3.49-6.60])), carbapenem-resistant Enterobacteriaceae (4.95% (95% CI [3.10-6.79])), and vancomycin-resistant Enterococcus (1.26% (95% CI [0.46-2.05])).<h4>Conclusion</h4>All the prevalences were considered as low. However, effective management and prevention of the infection should be considered since these coinfections have a bad impact on the morbidity and mortality of patients.