{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T17:38:54Z","timestamp":1763141934300,"version":"build-2065373602"},"reference-count":30,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,11,11]],"date-time":"2022-11-11T00:00:00Z","timestamp":1668124800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fondi Ricerca Scientifica di Ateneo","award":["243","394"],"award-info":[{"award-number":["243","394"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Patients with severe COVID-19, especially those followed in the ICU, are at risk for developing bacterial and fungal superinfections. In this study, we aimed to describe the burden of hospital-acquired superinfections in a cohort of consecutive, severe COVID-19 patients hospitalized between February and May 2021 in the intensive care unit (ICU) department of San Salvatore Hospital in Pesaro, Italy. Among 89 patients considered, 68 (76.4%) acquired a secondary infection during their ICU stay. A total of 46 cases of ventilator-associated pneumonia (VAP), 31 bloodstream infections (BSIs) and 15 catheter-associated urinary tract infections (CAUTIs) were diagnosed. Overall mortality during ICU stay was 48%. A multivariate analysis showed that factors independently associated with mortality were male gender (OR: 4.875, CI: 1.227\u201319.366, p = 0.024), higher BMI (OR: 4.938, CI:1.356\u201317.980, p = 0.015) and the presence of VAP (OR: 6.518, CI: 2.178\u201319.510, p = 0.001). Gram-negative bacteria accounted for most of the isolates (68.8%), followed by Gram-positive bacteria (25.8%) and fungi (5.3%). Over half of the infections (58%) were caused by MDR opportunistic pathogens. Factors that were independently associated with an increased risk of infections caused by an MDR pathogen were higher BMI (OR: 4.378, CI: 1.467\u201313.064, p = 0.0008) and a higher Charlson Comorbidity Index (OR: 3.451, 95% CI: 1.113\u201310.700, p = 0.032). Secondary infections represent a common and life-threatening complication in critically ill patients with COVID-19. Efforts to minimize the likelihood of acquiring such infections, often caused by difficult-to-treat MDR organisms\u2014especially in some subgroups of patients with specific risk factors\u2014must be pursued.<\/jats:p>","DOI":"10.3390\/antibiotics11111598","type":"journal-article","created":{"date-parts":[[2022,11,14]],"date-time":"2022-11-14T02:32:01Z","timestamp":1668393121000},"page":"1598","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Secondary Infections in Critically Ill Patients with COVID-19: A Retrospective Study"],"prefix":"10.3390","volume":"11","author":[{"given":"Luca","family":"Caiazzo","sequence":"first","affiliation":[{"name":"Malattie Infettive, Azienda Ospedaliera Ospedali Riuniti Marche Nord, 61121 Pesaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Temperoni","sequence":"additional","affiliation":[{"name":"Malattie Infettive, Azienda Ospedaliera Ospedali Riuniti Marche Nord, 61121 Pesaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benedetta","family":"Canovari","sequence":"additional","affiliation":[{"name":"Malattie Infettive, Azienda Ospedaliera Ospedali Riuniti Marche Nord, 61121 Pesaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oriana","family":"Simonetti","sequence":"additional","affiliation":[{"name":"Clinica Dermatologica, Dipartimento di Scienze Cliniche e Molecolari, Universit\u00e0 Politecnica delle Marche, 60126 Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3915-3851","authenticated-orcid":false,"given":"Roberto","family":"Montalti","sequence":"additional","affiliation":[{"name":"Unit\u00e0 di Chirurgia Epato-Bilio-Pancreatica, Mininvasiva e Robotica, Dipartimento di Sanit\u00e0 Pubblica, Universit\u00e0 Federico II, 80131 Napoli, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Barchiesi","sequence":"additional","affiliation":[{"name":"Malattie Infettive, Azienda Ospedaliera Ospedali Riuniti Marche Nord, 61121 Pesaro, Italy"},{"name":"Dipartimento di Scienze Biomediche e Sanit\u00e0 Pubblica, Universit\u00e0 Politecnica delle Marche, 60126 Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1111\/irv.12398","article-title":"The Frequency of Influenza and Bacterial Coinfection: A Systematic Review and Meta-Analysis","volume":"10","author":"Klein","year":"2016","journal-title":"Influenza Other Respir. 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