汕头大学医学院学报2024，Vol.37Issue(2)：76-80,84,6.DOI:10.13401/j.cnki.jsumc.2024.02.004
危重型COVID-19合并非病毒病原体感染的队列研究
A cohort study of critical COVID-19 co-infection with non-viral pathogens
摘要
Abstract
Objective:To investigate the current status of critical COVID-19 in combination with non-viral pathogens.Methods:Retrospective and prospective cohort study.Fifty-two patients with critical COVID-19 who were hospitalized in the intensive care unit of the Shenzhen Second People's Hospital from December 2022 to October 2023 were selected,including 30 cases in the retrospective cohort from December 2022 to January 2023 and 22 cases in the prospective cohort from February 2023 to October 2023.Patients were followed up at 3,7,21,30,60,and 90 d of enrolment,which included the results of patients' pathogenicity tests and hospital survival time.Blood and lower respiratory secretion samples were collected from the enrolled patients for bacterial culture and pathogenic metagenomics next generation sequencing.Results:Of the 52 patients with critical COVID-19,age 79(66,84)years,34(65.4%)were male,with a case-fatality rate of 34.6%(18/52).There were 47(90.4%)cases of mixed infections,of which 27(51.9%)were Gram-positive,29(55.8%)were Gram-negative,and 29(55.8%)were fungi.Metagenomics next generation sequencing had a higher detection rate of non-viral pathogens in lower respiratory secretions(76.9%vs.57.7%)and blood(46.2%vs.15.4%)than isolation culture methods.In the lower respiratory tract samples,Gram-positive bacteria were mainly Enterococcus faecalis(12 cases),Enterococcus faecalis(8 cases),and Staphylococcus aureus(6 cases),Gram-negative bacteria were mainly Pseudomonas aeruginosa(9 cases),Klebsiella pneumoniae(9 cases),Escherichia coli(7 cases),and Acinetobacter baumannii(6 cases),and fungi were mainly Candida albicans(15 cases)and Aspergillus(9 cases).Gram-negative bacteria in blood samples were mainly Klebsiella pneumoniae(6 cases),Pseudomonas aeruginosa(5 cases),and fungi were mainly Aspergillus(6 cases).Conclusion:Critical COVID-19 patients are often combined with bacterial and fungal infections.关键词
新型冠状病毒感染/危重型/宏基因组学测序/细菌培养Key words
COVID-19/critical type/metagenomic next-generation sequencing/bacterial culture分类
医药卫生引用本文复制引用
周艳,任迪,文莎,陈燕宏,桂水清,李颖..危重型COVID-19合并非病毒病原体感染的队列研究[J].汕头大学医学院学报,2024,37(2):76-80,84,6.基金项目
深圳市第二人民医院新冠病毒感染应急临床研究项目(2023xgyj3357003) （2023xgyj3357003）
