Respiratory pathogens co-infection in patients with COVID-19 pneumonia in Kazakhstan

Clinical evidence of the presence of bacterial co-infection in patients with SARS-CoV-2 pneumonia is important for an adequate treatment with antibacterial drugs. Objectives: to determine the secondary bacterial flora in patients with COVID pneumonia in patients in the Republic of Kazakhstan.

Prospective, microbiological, multicenter study, which was conducted at the Medical University of Karaganda in the Shared Resource Laboratory. Sputum samples were collected from three cities of Kazakhstan with the worst SARS-CoV-2 epidemiological situation. Microbiological examination was carried out using classical methods. All investigated isolates were identified to species by MALDI-TOF mass spectrometry. Susceptibility to antibiotics was performed by the disk diffusion method in accordance with the CLSI 2019 recommendations.

133 patients were included with a mean age of 60.9±12.7 years old, 53/133 (39.8%) had confirmed SARS-CoV-2 PCR test. Microbiological examination showed the growth of normal microflora in 31.45%. Difference in secondary bacterial co-infection etiology in COVID-19 positive and negative patients was not found. The leading place in general etiological structure belonged to K.pneumoniae - 22.64%, E.coli - 11.95% and A.baumannii - 11.32%. A significant relationship (p = 0.003) between such parameters as the use of antibacterial drugs and the isolated microflora was found.

Isolated microorganisms are etiologically significant and are pathogens of the ESKAPE group. It is important to limit the risk of infection and spread of resistant microorganisms by closely monitoring nosocomial infections and drawing attention to secondary infections caused by resistant bacteria that can increase the mortality rate of patients with COVID-19.