{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:14:14Z","timestamp":1789647254194,"version":"4.0.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,4,22]],"date-time":"2023-04-22T00:00:00Z","timestamp":1682121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["COV20\/00491"],"award-info":[{"award-number":["COV20\/00491"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI18\/01238"],"award-info":[{"award-number":["PI18\/01238"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014180","name":"Junta de Castilla y Le\u00f3n","doi-asserted-by":"publisher","award":["VA321P18"],"award-info":[{"award-number":["VA321P18"]}],"id":[{"id":"10.13039\/501100014180","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014180","name":"Junta de Castilla y Le\u00f3n","doi-asserted-by":"publisher","award":["GRS 1922\/A\/19"],"award-info":[{"award-number":["GRS 1922\/A\/19"]}],"id":[{"id":"10.13039\/501100014180","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014180","name":"Junta de Castilla y Le\u00f3n","doi-asserted-by":"publisher","award":["GRS 2057\/A\/19"],"award-info":[{"award-number":["GRS 2057\/A\/19"]}],"id":[{"id":"10.13039\/501100014180","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Consejer\u00eda de Educaci\u00f3n de Castilla y Le\u00f3n"},{"DOI":"10.13039\/100008054","name":"Fundaci\u00f3n Ram\u00f3n Areces","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]},{"name":"European Social Fund \u2018A"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>We performed a nationwide population-based retrospective study to describe the epidemiology of bacterial co-infections in coronavirus disease 2019 (COVID-19)-hospitalized patients in Spain in 2020. We also analyzed the risk factors for co-infection, the etiology and the impact in the outcome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data were obtained from records in the Minimum Basic Data Set (MBDS) of the National Surveillance System for Hospital Data in Spain, provided by the Ministry of Health and annually published with 2 years lag. COVID-19 circulated in two waves in 2020: from its introduction to 31st June and from 1st July to 31st December. The risk of developing a healthcare-associated bacterial co-infection and the risk for in-hospital and intensive care unit (ICU) mortality in co-infected patients was assessed using an adjusted logistic regression model.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The incidence of bacterial co-infection in COVID-19 hospitalized patients was 2.3%. The main risk factors associated with bacterial co-infection were organ failure, obesity and male sex. Co-infection was associated with worse outcomes including higher in-hospital, in-ICU mortality and higher length of stay. Gram-negative bacteria caused most infections. Causative agents were similar between waves, although higher co-infections with Pseudomonas spp. were detected in the first wave and with Haemophilus influenzae and Streptococcus pneumoniae in the second.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Co-infections are not as common as those found in other viral respiratory infections; therefore, antibiotics should be used carefully. Screening for actual co-infection to prescribe antibiotic therapy when required should be performed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurpub\/ckad060","type":"journal-article","created":{"date-parts":[[2023,4,23]],"date-time":"2023-04-23T00:28:46Z","timestamp":1682209726000},"page":"675-681","source":"Crossref","is-referenced-by-count":20,"title":["Epidemiology of bacterial co-infections and risk factors in COVID-19-hospitalized patients in Spain: a nationwide study"],"prefix":"10.1093","volume":"33","author":[{"given":"R","family":"L\u00f3pez-Herrero","sequence":"first","affiliation":[{"name":"BioCritic, Group for Biomedical Research in Critical Care Medicine , Valladolid, Spain"},{"name":"Anesthesiology and Critical Care Department, Hospital Cl\u00ednico Universitario de Valladolid , Valladolid, Spain"},{"name":"Department of Surgery, Faculty of Medicine, Universidad de Valladolid , Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"S\u00e1nchez-de Prada","sequence":"additional","affiliation":[{"name":"BioCritic, Group for Biomedical Research in Critical Care Medicine , Valladolid, Spain"},{"name":"Microbiology and Immunology Department, Hospital Cl\u00ednico Universitario de Valladolid , Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Tamayo-Velasco","sequence":"additional","affiliation":[{"name":"BioCritic, Group for Biomedical Research in Critical Care Medicine , Valladolid, Spain"},{"name":"Haematology and Hemotherapy Department, Hospital Cl\u00ednico Universitario de Valladolid , Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Lorenzo-L\u00f3pez","sequence":"additional","affiliation":[{"name":"BioCritic, Group for Biomedical Research in Critical Care Medicine , Valladolid, Spain"},{"name":"Anesthesiology and Critical Care Department, Hospital Cl\u00ednico Universitario de Valladolid , Valladolid, Spain"},{"name":"Department of Surgery, Faculty of Medicine, Universidad de Valladolid , Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"G\u00f3mez-Pesquera","sequence":"additional","affiliation":[{"name":"BioCritic, Group for Biomedical Research in Critical Care Medicine , Valladolid, Spain"},{"name":"Anesthesiology and Critical Care Department, Hospital Cl\u00ednico Universitario de Valladolid , Valladolid, Spain"},{"name":"Department of Surgery, Faculty of Medicine, Universidad de Valladolid , Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"S\u00e1nchez-Quir\u00f3s","sequence":"additional","affiliation":[{"name":"BioCritic, Group for Biomedical Research in Critical Care Medicine , Valladolid, Spain"},{"name":"Anesthesiology and Critical Care Department, Hospital Cl\u00ednico Universitario de Valladolid , Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O","family":"de la Varga-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"BioCritic, Group for Biomedical Research in Critical Care Medicine , Valladolid, Spain"},{"name":"Department of Anesthesiology, Hospital Universitario Infanta Leonor , Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"G\u00f3mez-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"BioCritic, Group for Biomedical Research in Critical Care Medicine , Valladolid, Spain"},{"name":"Anesthesiology and Critical Care Department, Hospital Cl\u00ednico Universitario de Valladolid , Valladolid, Spain"},{"name":"Department of Surgery, Faculty of Medicine, Universidad de Valladolid , Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Resino","sequence":"additional","affiliation":[{"name":"Unidad de Infecci\u00f3n Viral e Inmunidad, 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