{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T12:37:59Z","timestamp":1765370279502,"version":"build-2065373602"},"reference-count":40,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,7,12]],"date-time":"2023-07-12T00:00:00Z","timestamp":1689120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Intramural Research Program of the National Institutes of Health, Clinical Center"},{"name":"National Institute of Dental and Craniofacial Research"},{"name":"National Institute of Allergy and Infectious Diseases"},{"name":"NIH Medical Research Scholars Program"},{"name":"Doris Duke Charitable Foundation"},{"name":"Genentech"},{"name":"American Association for Dental Research"},{"name":"Colgate-Palmolive Company"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Bacterial and fungal co-infections are reported complications of coronavirus disease 2019 (COVID-19) in critically ill patients but may go unrecognized premortem due to diagnostic limitations. We compared the premortem with the postmortem detection of pulmonary co-infections in 55 fatal COVID-19 cases from March 2020 to March 2021. The concordance in the premortem versus the postmortem diagnoses and the pathogen identification were evaluated. Premortem pulmonary co-infections were extracted from medical charts while applying standard diagnostic definitions. Postmortem co-infection was defined by compatible lung histopathology with or without the detection of an organism in tissue by bacterial or fungal staining, or polymerase chain reaction (PCR) with broad-range bacterial and fungal primers. Pulmonary co-infection was detected premortem in significantly fewer cases (15\/55, 27%) than were detected postmortem (36\/55, 65%; p &lt; 0.0001). Among cases in which co-infection was detected postmortem by histopathology, an organism was identified in 27\/36 (75%) of cases. Pseudomonas, Enterobacterales, and Staphylococcus aureus were the most frequently identified bacteria both premortem and postmortem. Invasive pulmonary fungal infection was detected in five cases postmortem, but in no cases premortem. According to the univariate analyses, the patients with undiagnosed pulmonary co-infection had significantly shorter hospital (p = 0.0012) and intensive care unit (p = 0.0006) stays and significantly fewer extra-pulmonary infections (p = 0.0021). Bacterial and fungal pulmonary co-infection are under-recognized complications in critically ill patients with COVID-19.<\/jats:p>","DOI":"10.3390\/pathogens12070932","type":"journal-article","created":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T02:14:48Z","timestamp":1689214488000},"page":"932","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Pulmonary Co-Infections Detected Premortem Underestimate Postmortem Findings in a COVID-19 Autopsy Case Series"],"prefix":"10.3390","volume":"12","author":[{"given":"Andrew P.","family":"Platt","sequence":"first","affiliation":[{"name":"Emerging Pathogens Section, Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA"},{"name":"Laboratory of Virology, National Institute of Allergy and Infectious Diseases, Bethesda, MD 20892, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8064-9314","authenticated-orcid":false,"given":"Benjamin T.","family":"Bradley","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Utah, Salt Lake City, UT 84112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadia","family":"Nasir","sequence":"additional","affiliation":[{"name":"Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sydney R.","family":"Stein","sequence":"additional","affiliation":[{"name":"Emerging Pathogens Section, Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA"},{"name":"Laboratory of Virology, National Institute of Allergy and Infectious Diseases, Bethesda, MD 20892, 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M.","family":"Dickey","sequence":"additional","affiliation":[{"name":"Emerging Pathogens Section, Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA"},{"name":"Laboratory of Virology, National Institute of Allergy and Infectious Diseases, Bethesda, MD 20892, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madeleine","family":"Purcell","sequence":"additional","affiliation":[{"name":"University of Maryland School of Medicine, Baltimore, MD 21201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shreya","family":"Singireddy","sequence":"additional","affiliation":[{"name":"University of Maryland School of Medicine, Baltimore, MD 21201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Hays","sequence":"additional","affiliation":[{"name":"University of Maryland School of Medicine, Baltimore, MD 21201, 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Infect. Dis."},{"key":"ref_2","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":"Influ. Other Respir. Viruses"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"166","DOI":"10.2353\/ajpath.2010.100115","article-title":"2009 pandemic influenza A (H1N1): Pathology and pathogenesis of 100 fatal cases in the United States","volume":"177","author":"Shieh","year":"2010","journal-title":"Am. J. Pathol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1007\/s00134-020-06323-9","article-title":"Relationship between SARS-CoV-2 infection and the incidence of ventilator-associated lower respiratory tract infections: A European multicenter cohort study","volume":"47","author":"Rouze","year":"2021","journal-title":"Intensive Care Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"12703","DOI":"10.1038\/s41598-021-92220-0","article-title":"Secondary bacterial infection in COVID-19 patients is a stronger predictor for death compared to influenza patients","volume":"11","author":"Shafran","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"ofaa578","DOI":"10.1093\/ofid\/ofaa578","article-title":"Prevalence of Co-infection at the Time of Hospital Admission in COVID-19 Patients, A Multicenter Study","volume":"8","author":"Karaba","year":"2021","journal-title":"Open Forum Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1093\/cid\/ciaa762","article-title":"Bacterial Pneumonia in COVID-19 Critically Ill Patients: A Case Series","volume":"72","author":"Dudoignon","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"COVID-ICU Group on behalf of the REVA Network and the COVID-ICU Investigators (2021). Clinical characteristics and day-90 outcomes of 4244 critically ill adults with COVID-19: A prospective cohort study. Intensive Care Med., 47, 60\u201373.","DOI":"10.1007\/s00134-020-06294-x"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s41479-021-00083-w","article-title":"The role of co-infections and secondary infections in patients with COVID-19","volume":"13","author":"Feldman","year":"2021","journal-title":"Pneumonia"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Brandi, N., Ciccarese, F., Balacchi, C., Rimondi, M.R., Modolon, C., Sportoletti, C., Capozzi, C., Renzulli, M., Paccapelo, A., and Castelli, A. (2022). Co-Infections and Superinfections in COVID-19 Critically Ill Patients Are Associated with CT Imaging Abnormalities and the Worst Outcomes. Diagnostics, 12.","DOI":"10.3390\/diagnostics12071617"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1007\/s10096-020-04142-w","article-title":"Nosocomial infections associated to COVID-19 in the intensive care unit: Clinical characteristics and outcome","volume":"40","author":"Bardi","year":"2021","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/j.chest.2021.04.002","article-title":"Hospital-Acquired Infections in Critically Ill Patients With COVID-19","volume":"160","author":"Grasselli","year":"2021","journal-title":"Chest"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Brandi, N., Ciccarese, F., Rimondi, M.R., Balacchi, C., Modolon, C., Sportoletti, C., Renzulli, M., Coppola, F., and Golfieri, R. (2022). An Imaging Overview of COVID-19 ARDS in ICU Patients and Its Complications: A Pictorial Review. Diagnostics, 12.","DOI":"10.3390\/diagnostics12040846"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"ofab065","DOI":"10.1093\/ofid\/ofab065","article-title":"Bacterial Superinfections Among Persons With Coronavirus Disease 2019: A Comprehensive Review of Data From Postmortem Studies","volume":"8","author":"Clancy","year":"2021","journal-title":"Open Forum Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.cmi.2020.07.041","article-title":"Incidence of co-infections and superinfections in hospitalized patients with COVID-19: A retrospective cohort study","volume":"27","author":"Sanjuan","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"E48","DOI":"10.1016\/S2213-2600(20)30237-X","article-title":"Prevalence of putative invasive pulmonary aspergillosis in critically ill patients with COVID-19","volume":"8","author":"Alanio","year":"2020","journal-title":"Lancet Respir. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1111\/myc.13096","article-title":"COVID-19 associated pulmonary aspergillosis","volume":"63","author":"Koehler","year":"2020","journal-title":"Mycoses"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"18","DOI":"10.3201\/eid2701.202896","article-title":"Aspergillosis Complicating Severe Coronavirus Disease","volume":"27","author":"Marr","year":"2021","journal-title":"Emerg. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e20200401","DOI":"10.1590\/0037-8682-0401-2020","article-title":"Confirmed Invasive Pulmonary Aspergillosis and COVID-19: The value of postmortem findings to support antemortem management","volume":"53","author":"Santana","year":"2020","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.3201\/eid2704.204895","article-title":"COVID-19-Associated Pulmonary Aspergillosis, March-August 2020","volume":"27","author":"Sprute","year":"2021","journal-title":"Emerg. Infect. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e405","DOI":"10.1016\/S2666-5247(21)00091-4","article-title":"Invasive mould disease in fatal COVID-19: A systematic review of autopsies","volume":"2","author":"Kula","year":"2021","journal-title":"Lancet Microbe"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/S0140-6736(20)31305-2","article-title":"Histopathology and ultrastructural findings of fatal COVID-19 infections in Washington State: A case series","volume":"396","author":"Bradley","year":"2020","journal-title":"Lancet"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1038\/s41586-022-05542-y","article-title":"SARS-CoV-2 infection and persistence in the human body and brain at autopsy","volume":"612","author":"Stein","year":"2022","journal-title":"Nature"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"19","DOI":"10.15585\/mmwr.mm7101a4","article-title":"Risk Factors for Severe COVID-19 Outcomes Among Persons Aged >\/=18 Years Who Completed a Primary COVID-19 Vaccination Series\u2014465 Health Care Facilities, United States, December 2020\u2013October 2021","volume":"71","author":"Yek","year":"2022","journal-title":"MMWR Morb. Mortal Wkly. Rep."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1007\/s00134-020-06036-z","article-title":"Diagnosis of ventilator-associated pneumonia in critically ill adult patients-a systematic review and meta-analysis","volume":"46","author":"Fernando","year":"2020","journal-title":"Intensive Care Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e61","DOI":"10.1093\/cid\/ciw353","article-title":"Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society","volume":"63","author":"Kalil","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e0095521","DOI":"10.1128\/JCM.00955-21","article-title":"High Clinical Impact of Broad-Range Fungal PCR in Suspected Fungal Sinusitis","volume":"59","author":"Lieberman","year":"2021","journal-title":"J. Clin. Microbiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2773","DOI":"10.1128\/JCM.02888-14","article-title":"Bartonella quintana Aortitis in a Man with AIDS, Diagnosed by Needle Biopsy and 16S rRNA Gene Amplification","volume":"53","author":"Lee","year":"2015","journal-title":"J. Clin. Microbiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"4042","DOI":"10.1128\/JCM.39.11.4042-4051.2001","article-title":"Polymorphic internal transcribed spacer region 1 DNA sequences identify medically important yeasts","volume":"39","author":"Chen","year":"2001","journal-title":"J. Clin. Microbiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2302","DOI":"10.1128\/JCM.38.6.2302-2310.2000","article-title":"Identification of medically important yeasts using PCR-based detection of DNA sequence polymorphisms in the internal transcribed spacer 2 region of the rRNA genes","volume":"38","author":"Chen","year":"2000","journal-title":"J. Clin. Microbiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/S0022-2836(05)80360-2","article-title":"Basic local alignment search tool","volume":"215","author":"Altschul","year":"1990","journal-title":"J. Mol. Biol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"a005876","DOI":"10.1101\/mcs.a005876","article-title":"Identification of Leptotrichia goodfellowii infective endocarditis by next-generation sequencing of 16S rDNA amplicons","volume":"7","author":"Lieberman","year":"2021","journal-title":"Cold Spring Harb. Mol. Case Stud."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1373\/clinchem.2016.258806","article-title":"Clinical Next Generation Sequencing Outperforms Standard Microbiological Culture for Characterizing Polymicrobial Samples","volume":"62","author":"Cummings","year":"2016","journal-title":"Clin. Chem."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1016\/j.ajic.2013.09.002","article-title":"National Healthcare Safety Network (NHSN) report, data summary for 2012, Device-associated module","volume":"41","author":"Dudeck","year":"2013","journal-title":"Am. J. Infect. Control."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2427","DOI":"10.1001\/jama.2016.16226","article-title":"Trend in Ventilator-Associated Pneumonia Rates Between 2005 and 2013","volume":"316","author":"Metersky","year":"2016","journal-title":"JAMA"},{"key":"ref_36","first-page":"1071","article-title":"Bacterial coinfections in lung tissue specimens from fatal cases of 2009 pandemic influenza A (H1N1)\u2014United States, May-August 2009","volume":"58","author":"Louie","year":"2009","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1016\/j.cell.2020.08.001","article-title":"Severe COVID-19 Is Marked by a Dysregulated Myeloid Cell Compartment","volume":"182","author":"Reusch","year":"2020","journal-title":"Cell"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Babouee Flury, B., Weisser, M., Prince, S.S., Bubendorf, L., Battegay, M., Frei, R., and Goldenberger, D. (2014). Performances of two different panfungal PCRs to detect mould DNA in formalin-fixed paraffin-embedded tissue: What are the limiting factors?. BMC Infect. Dis., 14.","DOI":"10.1186\/s12879-014-0692-z"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1016\/j.cmi.2020.12.018","article-title":"Antibiotic prescribing in patients with COVID-19: Rapid review and meta-analysis","volume":"27","author":"Langford","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_40","first-page":"20499361221095732","article-title":"Improving management and antimicrobial stewardship for bacterial and fungal infections in hospitalized patients with COVID-19","volume":"9","author":"Peghin","year":"2022","journal-title":"Ther. Adv. Infect. Dis."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/12\/7\/932\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:11:28Z","timestamp":1760127088000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/12\/7\/932"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,12]]},"references-count":40,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["pathogens12070932"],"URL":"https:\/\/doi.org\/10.3390\/pathogens12070932","relation":{},"ISSN":["2076-0817"],"issn-type":[{"type":"electronic","value":"2076-0817"}],"subject":[],"published":{"date-parts":[[2023,7,12]]}}}