{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T20:33:01Z","timestamp":1788381181562,"version":"build-2803163510"},"reference-count":42,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T00:00:00Z","timestamp":1729209600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The outbreak of the COVID-19 pandemic caught healthcare systems in many countries unprepared. Shortages of personnel, medicines, disinfectants, and intensive care unit (ICU) capacities, combined with inadvertent use of antibiotics and emergence of drug-resistant secondary infections, led to a surge in COVID-19-related mortality. Objective: We aimed to evaluate the prevalence of secondary bacterial infections and the associated antibiotic resistance in a temporary established ICU dedicated to COVID-19 patients. We also assessed the utility of clinical and routine laboratory data as predictors of secondary infections and mortality in these patients. Methods: We examined the medical records of 243 patients admitted to the COVID-19 Medical Support Unit of T\u00e2rgu Mures, Romania, between 1 August 2020 and 31 January 2021. Results: Among the 243 patients admitted to the COVID-19 Medical Support Unit of T\u00e2rgu Mures between 1 August 2020 and 31 January 2021, 59 (24.3%) presented secondary infections. Acinetobacter baumannii and Klebsiella pneumoniae were the most frequent isolates (31.1% and 18.9%, respectively), most of them multidrug resistant. Chronic obstructive pulmonary disease had a higher prevalence in patients who developed secondary infections (p = 0.012). Secondary infections were associated with longer stay in the ICU and with higher mortality (p = 0.006 and p = 0.038, respectively). Conclusions: Early identification of secondary infections and proper use of antibiotics are necessary to limit the spread of multidrug-resistant microorganisms in COVID-19 patients admitted in the ICU.<\/jats:p>","DOI":"10.3390\/jcm13206201","type":"journal-article","created":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T06:46:52Z","timestamp":1729234012000},"page":"6201","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Secondary Bacterial Infections in Critically Ill COVID-19 Patients Admitted in the Intensive Care Unit of a Tertiary Hospital in Romania"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8276-444X","authenticated-orcid":false,"given":"Ionela-Anca","family":"Pintea-Simon","sequence":"first","affiliation":[{"name":"Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mures, 540142 Targu Mures, Romania"},{"name":"Department of Internal Medicine M3, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mures, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ligia","family":"Bancu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine M3, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mures, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anca Delia","family":"Mare","sequence":"additional","affiliation":[{"name":"Department of Microbiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mures, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2262-7456","authenticated-orcid":false,"given":"Cristina Nicoleta","family":"Ciurea","sequence":"additional","affiliation":[{"name":"Department of Microbiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mures, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicia","family":"Toma","sequence":"additional","affiliation":[{"name":"Department of Microbiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mures, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u0103d\u0103lina Cristina","family":"Brukner","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mures, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2880-4337","authenticated-orcid":false,"given":"Anca-Meda","family":"V\u0103sie\u0219iu","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mures, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5281-0601","authenticated-orcid":false,"given":"Adrian","family":"Man","sequence":"additional","affiliation":[{"name":"Department of Microbiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of T\u00e2rgu Mures, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"100618","DOI":"10.1016\/j.cpcardiol.2020.100618","article-title":"COVID-19 and Multiorgan Response","volume":"45","author":"Zaim","year":"2020","journal-title":"Curr. 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