Next Article in Journal
SARS-CoV-2 Coronavirus Disease in Patients with Underlying Congenital Inferior Vena Cava Anomalies
Next Article in Special Issue
Longitudinal Symptom Analysis of COVID-19 Survivors and Post-COVID Syndrome Patients
Previous Article in Journal
Impact of the Female Genital Microbiota on Outcomes of Assisted Reproductive Techniques
Previous Article in Special Issue
Evaluation of suPAR as a Key Prognostic Biomarker in Patients with SARS-CoV-2 Pneumonia
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
Biomedicines
Volume 13
Issue 6
10.3390/biomedicines13061333
biomedicines-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Incidence and Risk Factors of Secondary Infections in Critically Ill SARS-CoV-2 Patients: A Retrospective Study in an Intensive Care Unit

by
Mircea Stoian
1,
Leonard Azamfirei
1,
Adina Andone
2,*,
Anca-Meda Văsieșiu
3,
Andrei Stîngaciu
4,
Adina Huțanu
5,6,
Sergio Rareș Bândilă
7,
Daniela Dobru
2,
Andrei Manea
8,9 and
Adina Stoian
10
1
Department of Anesthesiology and Intensive Care Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540103 Târgu Mureș, Romania
2
Gastroenterology Department, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania
3
Department of Infections Disease, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania
4
Intensive Care Unit, Mures, County Hospital, Street Gheorghe Marinescu no. 1, 540136 Târgu Mureș, Romania
5
Department of Laboratory Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania
6
Center for Advanced Medical and Pharmaceutical Research, Immunology, University of Medicine, Pharmacy, Science and Technology “George Emil Palade”, 540142 Târgu Mureș, Romania
7
Orthopedic Surgery and Traumatology Service, Marina Baixa Hospital, Av. Alcade En Jaume Botella Mayor, 03570 Villajoyosa, Spain
8
Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania
9
Department of Radiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania
10
Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540136 Târgu Mureș, Romania
*
Author to whom correspondence should be addressed.
Biomedicines 2025, 13(6), 1333; https://doi.org/10.3390/biomedicines13061333
Submission received: 29 April 2025 / Revised: 27 May 2025 / Accepted: 28 May 2025 / Published: 29 May 2025
(This article belongs to the Special Issue The End of the COVID-19 Pandemic—What Is Currently Known and What Could Have Been Useful Four Years Ago? (2nd Edition))
Versions Notes

Abstract

Background/Objectives: The clinical forms of coronavirus disease 2019 (COVID-19) vary widely in severity, ranging from asymptomatic or moderate cases to severe pneumonia that can lead to acute respiratory failure, acute respiratory distress syndrome, multiple organ dysfunction syndrome, and death. Our main objective was to determine the prevalence of bacterial and fungal secondary infections in an intensive care unit (ICU). Secondary objectives included analyzing the impact of these infections on mortality and medical resource utilization, as well as assessing antimicrobial resistance in this context. Methods: We conducted a retrospective cohort study that included critically ill severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients treated in an ICU and analyzed the prevalence of co-infections and superinfections. Results: A multivariate analysis of mortality found that the presence of superinfections increased the odds of death by more than 15-fold, while the Sequential Organ Failure Assessment (SOFA) score and C-reactive protein (adjusted for confounders) increased the odds of mortality by 51% and 13%, respectively. The antibiotic resistance profile of microorganisms indicated a high prevalence of resistant strains. Carbapenems, glycopeptides, and oxazolidinones were the most frequently used classes of antibiotics. Among patients, 27.9% received a single antibiotic, 47.5% received two from different classes, and 24.4% were treated with three or more. Conclusions: The incidence and spectrum of bacterial and fungal superinfections are higher in critically ill ICU patients, leading to worse outcomes in COVID-19 cases. Multidrug-resistant pathogens present significant challenges for ICU and public health settings. Early screening, accurate diagnosis, and minimal use of invasive devices are essential to reduce risks and improve patient outcomes.
Keywords: COVID-19; superinfections; bacterial infections; fungal infections; antibiotic resistance COVID-19; superinfections; bacterial infections; fungal infections; antibiotic resistance

Share and Cite

MDPI and ACS Style

Stoian, M.; Azamfirei, L.; Andone, A.; Văsieșiu, A.-M.; Stîngaciu, A.; Huțanu, A.; Bândilă, S.R.; Dobru, D.; Manea, A.; Stoian, A. Incidence and Risk Factors of Secondary Infections in Critically Ill SARS-CoV-2 Patients: A Retrospective Study in an Intensive Care Unit. Biomedicines 2025, 13, 1333. https://doi.org/10.3390/biomedicines13061333

AMA Style

Stoian M, Azamfirei L, Andone A, Văsieșiu A-M, Stîngaciu A, Huțanu A, Bândilă SR, Dobru D, Manea A, Stoian A. Incidence and Risk Factors of Secondary Infections in Critically Ill SARS-CoV-2 Patients: A Retrospective Study in an Intensive Care Unit. Biomedicines. 2025; 13(6):1333. https://doi.org/10.3390/biomedicines13061333

Chicago/Turabian Style

Stoian, Mircea, Leonard Azamfirei, Adina Andone, Anca-Meda Văsieșiu, Andrei Stîngaciu, Adina Huțanu, Sergio Rareș Bândilă, Daniela Dobru, Andrei Manea, and Adina Stoian. 2025. "Incidence and Risk Factors of Secondary Infections in Critically Ill SARS-CoV-2 Patients: A Retrospective Study in an Intensive Care Unit" Biomedicines 13, no. 6: 1333. https://doi.org/10.3390/biomedicines13061333

APA Style

Stoian, M., Azamfirei, L., Andone, A., Văsieșiu, A.-M., Stîngaciu, A., Huțanu, A., Bândilă, S. R., Dobru, D., Manea, A., & Stoian, A. (2025). Incidence and Risk Factors of Secondary Infections in Critically Ill SARS-CoV-2 Patients: A Retrospective Study in an Intensive Care Unit. Biomedicines, 13(6), 1333. https://doi.org/10.3390/biomedicines13061333

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop