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10.1007/s15010-022-01796-w http://scihub22266oqcxt.onion/10.1007/s15010-022-01796-w 35420370!9008382!35420370     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=35420370&cmd=llinks): Failed to open stream: HTTP request failed! 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Characterization of antimicrobial use and co-infections among hospitalized patients with COVID-19: a prospective observational cohort study |pdf=|usr=}}{{35420370}} gab.com Text Characterization of antimicrobial use and co-infections among hospitalized patients with COVID-19: a prospective observational cohort study JO: Infection http://www.kidney.de/pget.php?&tw=1&pmid=35420370 #FOAvip PURPOSE: To investigate antimicrobial use and primary and nosocomial infections in hospitalized COVID-19 patients to provide data for guidance of antimicrobial therapy. METHODS: Prospective observational cohort study conducted at Charite-Universitatsmedizin Berlin, including patients hospitalized with SARS-CoV-2-infection between March and November 2020. RESULTS: 309 patients were included, 231 directly admitted and 78 transferred from other centres. Antimicrobial therapy was initiated in 62/231 (26.8%) of directly admitted and in 44/78 (56.4%) of transferred patients. The rate of microbiologically confirmed primary co-infections was 4.8% (11/231). Although elevated in most COVID-19 patients, C-reactive protein and procalcitonin levels were higher in patients with primary co-infections than in those without (median CRP 110 mg/l, IQR 51-222 vs. 36, IQR 11-101, respectively; p < 0.0001). Nosocomial bloodstream and respiratory infections occurred in 47/309 (15.2%) and 91/309 (29.4%) of patients, respectively, and were associated with need for invasive mechanical ventilation (OR 45.6 95%CI 13.7-151.8 and 104.6 95%CI 41.5-263.5, respectively), extracorporeal membrane oxygenation (OR 14.3 95%CI 6.5-31.5 and 16.5 95%CI 6.5-41.6, respectively), and haemodialysis (OR 31.4 95%CI 13.9-71.2 and OR 22.3 95%CI 11.2-44.2, respectively). The event of any nosocomial infection was significantly associated with in-hospital death (33/99 (33.3%) with nosocomial infection vs. 23/210 (10.9%) without, OR 4.1 95%CI 2.2-7.3). CONCLUSIONS: Primary co-infections are rare, yet antimicrobial use was frequent, mostly based on clinical worsening and elevated inflammation markers without clear evidence for co-infection. More reliable diagnostic prospects may help to reduce overtreatment. Rates of nosocomial infections are substantial in severely ill patients on organ support and associated with worse patient outcome. Twit Text FOAVip Characterization of antimicrobial use and co-infections among hospitalized patients with COVID-19: a prospective observational cohort study ????Infection http://www.kidney.de/pget.php?&tw=1&pmid=35420370 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=35420370 #FOAvip English Wikipedia <ref>{{Cite pmid|35420370}}</ref> Characterization of antimicrobial use and co-infections among hospitalized patients with COVID-19: a prospective observational cohort study #MMPMID35420370 Lingscheid T; Lippert LJ; Hillus D; Kruis T; Thibeault C; Helbig ET; Tober-Lau P; Pfafflin F; Muller-Redetzky H; Witzenrath M; Zoller T; Uhrig A; Opitz B; Suttorp N; Kramer TS; Sander LE; Stegemann MS; Kurth F Infection 2022[Dec]; 50 (6): 1441-1452 PMID35420370show ga PURPOSE: To investigate antimicrobial use and primary and nosocomial infections in hospitalized COVID-19 patients to provide data for guidance of antimicrobial therapy. METHODS: Prospective observational cohort study conducted at Charite-Universitatsmedizin Berlin, including patients hospitalized with SARS-CoV-2-infection between March and November 2020. RESULTS: 309 patients were included, 231 directly admitted and 78 transferred from other centres. Antimicrobial therapy was initiated in 62/231 (26.8%) of directly admitted and in 44/78 (56.4%) of transferred patients. The rate of microbiologically confirmed primary co-infections was 4.8% (11/231). Although elevated in most COVID-19 patients, C-reactive protein and procalcitonin levels were higher in patients with primary co-infections than in those without (median CRP 110 mg/l, IQR 51-222 vs. 36, IQR 11-101, respectively; p < 0.0001). Nosocomial bloodstream and respiratory infections occurred in 47/309 (15.2%) and 91/309 (29.4%) of patients, respectively, and were associated with need for invasive mechanical ventilation (OR 45.6 95%CI 13.7-151.8 and 104.6 95%CI 41.5-263.5, respectively), extracorporeal membrane oxygenation (OR 14.3 95%CI 6.5-31.5 and 16.5 95%CI 6.5-41.6, respectively), and haemodialysis (OR 31.4 95%CI 13.9-71.2 and OR 22.3 95%CI 11.2-44.2, respectively). The event of any nosocomial infection was significantly associated with in-hospital death (33/99 (33.3%) with nosocomial infection vs. 23/210 (10.9%) without, OR 4.1 95%CI 2.2-7.3). CONCLUSIONS: Primary co-infections are rare, yet antimicrobial use was frequent, mostly based on clinical worsening and elevated inflammation markers without clear evidence for co-infection. More reliable diagnostic prospects may help to reduce overtreatment. Rates of nosocomial infections are substantial in severely ill patients on organ support and associated with worse patient outcome. |*Anti-Infective Agents/therapeutic use[MESH] |*COVID-19 Drug Treatment[MESH] |*COVID-19/epidemiology[MESH] |*Coinfection/drug therapy/epidemiology[MESH] |*Cross Infection/drug therapy/epidemiology[MESH] |Hospital Mortality[MESH] |Humans[MESH] |Prospective Studies[MESH]Characterization of antimicrobial use and co-infections among hospital(epmc).pdf DeepDyve Pubget Overpricing