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Table 2 Sputum culture results related to timing of pneumonia diagnosis and intubation

From: Bacterial and fungal growth in sputum cultures from 165 COVID-19 pneumonia patients requiring intubation: evidence for antimicrobial resistance development and analysis of risk factors

 

PNA on ADM before intubation (n = 33)

PNA w/in 24 h of intubation (n = 165)

Late PNA ≥ 1 week after intubation (n = 80)

Colonization ≥ 1 week after intubation (n = 31)

No. (%) receiving antibiotics

(n = 18, 54.5%)

(n = 144, 87.3%)

(n = 80, 100%)

(n = 20, 64.5%)

No sputum obtained (50)*

26

21

3

–

Ordered, not done (6)

1

4

1

-

Without growth (12)

–

11

–

1

Normal oral flora only (83)

4

62

13

4

Contaminated (1)

1

–

–

–

Yeast ± normal oral flora (33)

–

16

12

5

Solitary Gram-positive (47)

    

 MSSA

–

17

9

2

 MRSA

1

6

8

–

 Staph pseudintermedius

–

–

1

–

 Streptococcus mitis

–

1

–

–

 Streptococcus pyogenes

–

1

–

–

 Streptococcus pneumoniae

–

–

1

–

Solitary Gram-negative (51)

    

 Pseudomonas aeruginosa

–

3

14

8

 Escherichia coli

–

4

–

–

 Proteus mirabilis

–

1

2

1

 Citrobacter koseri

–

2

1

2

 Enterobacter a/c

–

1

3

2

 Klebsiella pneumoniae

–

–

2

1

 Serratia marscescens

–

–

1

–

 Burkholderia cepacia

–

–

1

–

 Haemophilus influenzae

–

1

–

–

 Moraxella catarrhalis

–

1

–

–

Combination (Gram pos/pos) (1)

    

 Alpha strep not gr A, MSSA

–

–

–

1

Combination (Gram pos/neg) (14)

    

 MSSA, E. coli

–

2

–

–

 MSSA, Klebsiella p

–

1

1

1

 MSSA, Proteus m

–

–

–

1

 MSSA, Ps. a

–

–

1

–

 MRSA, E. coli

–

1

–

–

 MRSA, Enterobacter a., Ps. a

–

1

–

–

 MRSA, H. influenzae, Ps. a

–

1

–

–

 MRSA, Proteus m

–

–

–

1

 MRSA, Ps. a

–

–

2

–

 Strep pneumoniae, E. coli

–

1

–

–

Combination (Gram neg/neg) (8)

    

 Ps. a., Acinetobacter c

–

1

–

1

 Ps. a., Enterobacter c

–

–

1

–

 Ps. a., E. coli

–

1

–

–

 Ps. a., Klebsiella p

–

–

1

–

 Achromobacter x., Proteus m

–

1

–

–

 Citrobacter k., Klebsiella p

–

–

1

–

 E. coli, Proteus m

–

–

1

–

Other fungi (3)

    

 Aspergillus species

–

3

–

–

Residence vs. culture results

    

 Home

20 (60.6% total)

84 (50.9%)

57 (71.2%)

21 (67.7%)

 Group Home

3 (9.1%)

10 (6.1%)

4 (5.0%)

0 (0%)

 Nursing Home

10 (30.3%)

71 (43.0%)

19 (23.8%)

10 (32.3%)

ADM CXR, not intubated (33)

    

 GGO only

30 (3 normal flora, yeast; 26 no sputum; 1 contaminated)

   

 Includes consolidation

3 (1 normal flora, 1 ordered, not done, 1 MRSA)

   

CXR at intubation (165)

    

 Predom. interstitial, GGO

35 (22 normal flora, yeast; 6 no sputum, 4 no culture growth, 1 MSSA, 2 MRSA)

   

 Predom. consolidation

130 (56 normal flora, yeast; 15 no sputum; 7 no growth; 4 ordered, not done; 48 potential pathogens most common = 16 MSSA, 4 MRSA, 4 E. coli, 3 Ps. a.)

   

Intubation culture vs. residence, outcome

Isolate nos

From group or nursing home no. (%)

Overall mortality (%)

Normal flora or yeast

78

44 (43.6%)

(56.4%)

MSSA only

17

12 (70.6%)

(64.7%)

MRSA only

6

6 (100.0%)

(100.0%)

Pseudomonas a. only

3

2 (66.7%)

(66.7%)

Aspergillus only

3

2 (66.7%)

(66.7%)

Any MSSA in culture

20

12 (60.0%)

(70.0%)

Any MRSA in culture

9

9 (100.0%)

(88.9%)

Any Ps. a. in culture

7

6 (85.7%)

(71.4%)

  1. PNA pneumonia, ADM admission, MSSA methicillin-susceptible Staphylococcus aureus, MRSA methicillin-resistant Staphylococcus aureus, Staph pseudintermedius Staphylococcus pseudintermedius, Enterobacter a./c. Enterobacter aerogenes/cloacae, Alpha strep not group A alpha streptococcus not group A, Ps. a. Pseudomonas aeruginosa, H. influenzae Haemophilus influenzae, Proteus m. Proteus mirabilis, E. coli Escherichia coli, Klebsiella p. Klebsiella pneumoniae, Acinetobacter c. Acinetobacter calcoaceticus, Achromobacer x. Achromobacter xylosoxidans, Citrobacter k. Citrobacter koseri
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Annals of Clinical Microbiology and Antimicrobials

ISSN: 1476-0711

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