CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL
Vol. 6 No. 1 (2025): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL

Bacterial and Fungal Coinfections in COVID-19 Inpatients at a Tertiary Hospital in Surabaya, Indonesia, from November 2020 to February 2022

Shabira, Naura Ghina (Unknown)
Widodo, Agung Dwi Wahyu (Unknown)
Rusli, Musofa (Unknown)



Article Info

Publish Date
31 Jan 2025

Abstract

Introduction: After the first discovery of coronavirus disease 2019 (COVID-19) in 2020, the rapid increase of cases beyond China prompted the declaration of a pandemic. Elevated rates of bacterial-fungal coinfection were observed in hospitalized COVID-19 patients. This study aimed to determine the profiles of bacterial and fungal coinfections in COVID-19 patients diagnosed between November 2020 and February 2022 at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Methods: This retrospective descriptive study obtained data from medical records and used total sampling to assemble 278 COVID-19 patients who met the inclusion criteria. The evaluated variables were subject characteristics, including age, sex, comorbidities, length of stay, ventilator use, bacterial coinfections, fungal coinfections, and bacterial-fungal coinfections. Results: The age group of 55–64 years (26.9%) was predominant among the patients, with males (55.4%) outnumbering females. Hypertension was the most prevalent comorbidity (15.8%). The patients were mostly hospitalized for over ten days (66.2%). Eleven patients (4%) were admitted to the intensive care unit, and five patients (1.8%) required mechanical ventilation. The bacterial coinfections were primarily caused by Streptococcus viridans (56.6%), found in 145 sputum specimens, followed by Klebsiella pneumoniae (23.4%). The predominant isolates in the bacterial-fungal coinfections were Streptococcus viridans and Candida albicans (24.8%), identified in 125 sputum specimens, followed by Klebsiella pneumoniae and Candida albicans (18.4%). Conclusion: COVID-19 patients with bacterial-fungal coinfections present certain characteristics, including being male, middle-aged, hypertensive, and hospitalized beyond ten days. Streptococcus viridans, Klebsiella pneumoniae, and Candida albicans are common etiologies in bacterial-fungal coinfections.   Highlights: 1. This study overviews the distribution of patients and causative pathogens associated with bacterial, fungal, and bacterial-fungal coinfections, which have escalated with the rapid rise of coronavirus disease 2019 (COVID-19) hospitalization. 2. Data on the causative pathogens of bacterial-fungal coinfection in COVID-19 patients can be considered in the development of guidelines for empirical therapy in clinical practice.  

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