{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T10:32:51Z","timestamp":1769164371529,"version":"3.49.0"},"reference-count":28,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T00:00:00Z","timestamp":1657065600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objective: Bacterial infections are among the major complications of many viral respiratory tract illnesses, such as influenza and coronavirus disease-2019 (COVID-19). These bacterial co-infections are associated with an increase in morbidity and mortality rates. The current observational study was conducted at a tertiary care hospital in Lahore, Pakistan among COVID-19 patients with the status of oxygen dependency to see the prevalence of bacterial co-infections and their antibiotic susceptibility patterns. Materials and Methods: A total of 1251 clinical samples were collected from already diagnosed COVID-19 patients and tested for bacterial identification (cultures) and susceptibility testing (disk diffusion and minimum inhibitory concentration) using gold standard diagnostic methods. Results: From the total collected samples, 234 were found positive for different bacterial isolates. The most common isolated bacteria were Escherichia coli (E. coli) (n = 62) and Acinetobacter baumannii (A. baumannii) (n = 47). The E. coli isolates have shown the highest resistance to amoxicillin and ampicillin, while in the case of A. baumannii, the highest resistance was noted against tetracycline. The prevalence of methicillin resistant Staphylococcus aureus (MRSA) was 14.9%, carbapenem resistant Enterobacteriaceae (CRE) was 4.5%, and vancomycin resistant Enterococcus (VRE) was 3.96%. Conclusions: The results of the current study conclude that empiric antimicrobial treatment in critically ill COVID-19 patients may be considered if properly managed within institutional or national level antibiotic stewardship programs, because it may play a protective role in the case of bacterial co-infections, especially when a patient has other AMR risk factors, such as hospital admission within the previous six months.<\/jats:p>","DOI":"10.3390\/medicina58070904","type":"journal-article","created":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T21:15:52Z","timestamp":1657142152000},"page":"904","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Evaluation of Bi-Lateral Co-Infections and Antibiotic Resistance Rates among COVID-19 Patients in Lahore, Pakistan"],"prefix":"10.3390","volume":"58","author":[{"given":"Azka","family":"Rizvi","sequence":"first","affiliation":[{"name":"Department of Microbiology, Pakistan Kidney and Liver Institute & Research Center, Lahore 54000, Punjab, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Umer","family":"Saeed","sequence":"additional","affiliation":[{"name":"Department of Medical Education, King Edward Medical University, Lahore 54000, Punjab, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayesha","family":"Nadeem","sequence":"additional","affiliation":[{"name":"Department of Medical Education, King Edward Medical University, Lahore 54000, Punjab, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asma","family":"Yaqoob","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Fatima Memorial Medical and Dental College, Lahore 54000, Punjab, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6774-9847","authenticated-orcid":false,"given":"Ali A.","family":"Rabaan","sequence":"additional","affiliation":[{"name":"Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia"},{"name":"College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"},{"name":"Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Khyber Pakhtunkhwa, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2284-3979","authenticated-orcid":false,"given":"Muhammed A.","family":"Bakhrebah","sequence":"additional","affiliation":[{"name":"Life Science and Environment Research Institute, King Abdulaziz City for Science and Technology (KACST), Riyadh 11442, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abbas","family":"Al Mutair","sequence":"additional","affiliation":[{"name":"Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia"},{"name":"College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia"},{"name":"School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia"},{"name":"Nursing Department, Prince Sultan Military College of Health Sciences, Dhahran 33048, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4552-4513","authenticated-orcid":false,"given":"Saad","family":"Alhumaid","sequence":"additional","affiliation":[{"name":"Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5335-2809","authenticated-orcid":false,"given":"Mohammed","family":"Aljeldah","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Hafr Al Batin, Hafr Al Batin 39831, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3522-0607","authenticated-orcid":false,"given":"Basim R.","family":"Al Shammari","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Hafr Al Batin, Hafr Al Batin 39831, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hawra","family":"Albayat","sequence":"additional","affiliation":[{"name":"Infectious Disease Department, King Saud Medical City, Riyadh 7790, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7290-8945","authenticated-orcid":false,"given":"Ameen S. S.","family":"Alwashmi","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0989-4023","authenticated-orcid":false,"given":"Firzan","family":"Nainu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4435-3003","authenticated-orcid":false,"given":"Yousef N.","family":"Alhashem","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Sciences, Mohammed AlMana College of Health Sciences, Dammam 34222, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4333-8226","authenticated-orcid":false,"given":"Muhammad","family":"Naveed","sequence":"additional","affiliation":[{"name":"Department of Biotechnology, Faculty of Science and Technology, University of Central Punjab, Lahore 54000, Punjab, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1504-1705","authenticated-orcid":false,"given":"Naveed","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Biotechnology, Faculty of Science and Technology, University of Central Punjab, Lahore 54000, Punjab, Pakistan"},{"name":"Department of Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41419-020-02995-9","article-title":"COVID19: An announced pandemic","volume":"11","author":"Platto","year":"2020","journal-title":"Cell Death Dis."},{"key":"ref_2","first-page":"1710","article-title":"COVID-19 and public awareness","volume":"27","author":"Ahmed","year":"2020","journal-title":"Prof. Med. 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