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Medicina crítica (Colegio Mexicano de Medicina Crítica)
Print version ISSN 2448-8909
Abstract
GONZALEZ PEREZ, Netzahualcóyotl; VILLAFUERTE TORAL, Griselda and LOPEZ CARRILLO, Lilia. Survival in patients with severe SARS-CoV-2 pneumonia with superinfection in an Intensive Care Unit. Med. crít. (Col. Mex. Med. Crít.) [online]. 2021, vol.35, n.5, pp.237-242. Epub May 23, 2022. ISSN 2448-8909. https://doi.org/10.35366/102351.
Introduction:
Superinfection in patients with severe acute respiratory syndrome by coronavirus 2 (SARS-CoV-2) is not completely understood and requires attention to avoid the excessive use of antibiotics.
Material and methods:
Observational, retrospective, longitudinal, comparative study in patients with severe SARS-CoV-2 pneumonia. The accumulated probability of individual survival over 90 days was calculated with the Kaplan Meier m ethod, in groups with superinfection or absence of development of isolated microorganisms using cultures of bronchial secretion, central and peripheral blood cultures, and urine cultures.
Results:
Eighty-two patients were recruited, 21 (25.6%) presented bacterial or fungal growth in cultures of bronchial secretion, eight (9.7%) presented bacterial growth in peripheral blood cultures, five (6%) had bacterial development in central blood cultures, and 16 (19.5%) presented bacterial or fungal growth in urine cultures. Survival in these patients was lower, without being significant, with respect to those who did not have superinfection, (p = 0.352, 0.280, 0.119, 0.302 respectively).
Conclusion:
Superinfection in patients with severe SARS-CoV-2 pneumonia has not been shown to be a factor associated with lower survival, and although the prevalence of superinfection is not negligible, there is insufficient evidence to support the generalized use of empirical antibiotics.
Keywords : SARS-CoV-2; superinfection; mechanical ventilation; survival.