scholarly journals Staphylococcus aureus Bacteremia in Patients Infected With COVID-19: A Case Series

2020 ◽  
Vol 7 (11) ◽  
Author(s):  
Jaclyn A Cusumano ◽  
Amy C Dupper ◽  
Yesha Malik ◽  
Elizabeth M Gavioli ◽  
Jaspreet Banga ◽  
...  

Abstract Background Previous viral pandemics have shown that secondary bacterial infections result in higher morbidity and mortality, with Staphylococcus aureus being the primary causative pathogen. The impact of secondary S. aureus bacteremia on mortality in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains unknown. Methods This was a retrospective observational case series of patients with coronavirus disease 2019 (COVID-19) who developed secondary S. aureus bacteremia across 2 New York City hospitals. The primary end point was to describe 14-day and 30-day hospital mortality rates of patients with COVID-19 and S. aureus bacteremia. Secondary end points included predictors of 14-day and 30-day hospital mortality in patients with COVID-19 and S. aureus bacteremia. Results A total of 42 patients hospitalized for COVID-19 with secondary S. aureus bacteremia were identified. Of these patients, 23 (54.8%) and 28 (66.7%) died at 14 days and 30 days, respectively, from their first positive blood culture. Multivariate analysis identified hospital-onset bacteremia (≥4 days from date of admission) and age as significant predictors of 14-day hospital mortality and Pitt bacteremia score as a significant predictor of 30-day hospital mortality (odds ratio [OR], 11.9; 95% CI, 2.03–114.7; P = .01; OR, 1.10; 95% CI, 1.03–1.20; P = .02; and OR, 1.56; 95% CI, 1.19–2.18; P = .003, respectively). Conclusions Bacteremia with S. aureus is associated with high mortality rates in patients hospitalized with COVID-19. Further investigation is warranted to understand the impact of COVID-19 and secondary S. aureus bacteremia.

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0257979
Author(s):  
Michael J. Satlin ◽  
Jason Zucker ◽  
Benjamin R. Baer ◽  
Mangala Rajan ◽  
Nathaniel Hupert ◽  
...  

Public health interventions such as social distancing and mask wearing decrease the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, but it is unclear whether they decrease the viral load of infected patients and whether changes in viral load impact mortality from coronavirus disease 2019 (COVID-19). We evaluated 6923 patients with COVID-19 at six New York City hospitals from March 15-May 14, 2020, corresponding with the implementation of public health interventions in March. We assessed changes in cycle threshold (CT) values from reverse transcription-polymerase chain reaction tests and in-hospital mortality and modeled the impact of viral load on mortality. Mean CT values increased between March and May, with the proportion of patients with high viral load decreasing from 47.7% to 7.8%. In-hospital mortality increased from 14.9% in March to 28.4% in early April, and then decreased to 8.7% by May. Patients with high viral loads had increased mortality compared to those with low viral loads (adjusted odds ratio 2.34). If viral load had not declined, an estimated 69 additional deaths would have occurred (5.8% higher mortality). SARS-CoV-2 viral load steadily declined among hospitalized patients in the setting of public health interventions, and this correlated with decreases in mortality.


2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S511-S511
Author(s):  
Nimra Chaudhry ◽  
Eris Cani ◽  
Tae Park ◽  
Cosmina Zeana ◽  
Paul Kelly ◽  
...  

Abstract Background Limited data exists regarding the impact of coronavirus disease 2019 (COVID-19) on people living with human immunodeficiency virus (PLWH). The purpose of the study was to compare the clinical outcomes of patients hospitalized with COVID-19 and HIV versus those without HIV. Methods This was a retrospective, cohort study of adult patients admitted with confirmed COVID-19 from March 1st to May 30th 2020 at an urban hospital in New York City. Data collected included demographics, past medical history, HIV status, baseline laboratory values, treatment and outcomes such as length of stay, mechanical ventilation, patient disposition at discharge, and in-hospital mortality. Fisher’s exact test was used to compare categorical values and a t-test was used to compare continuous values. Results Out of 983 patients, 6.9% were PLWH and 93.1% were HIV-negative. The average age in both groups was 61 vs. 62 years, respectively. There were more male patients in the PLWH than the non-HIV group (76.8% vs. 58.6%). Majority of PLWH were Black (49.3%). Forty-seven percent of PLWH were mechanically ventilated versus 33.3% of the non-HIV group. The most common comorbidity in both groups was hypertension (82.4% vs. 72.6%). When compared to HIV-negative patients, PLWH had a higher rate of kidney disease (72.1% vs. 53.6%, p=0.0086), chronic obstructive pulmonary disease (41.2% vs. 14.5%, p=0.0001), liver disease (45.6% vs. 11.5%, p=0.0001) and current smoking (14.3% vs. 5.8%, p=0.0103). In PLWH, 70.6% of patients were on an integrase-based regimen. Fifty-three percent of PLWH had a CD4 count of > 200 cells/mm3 and 35.3% had an undetectable viral load (< 20 copies/mL). Unadjusted hospital mortality was 51.4% in PLWH and 36.2% in the non-HIV cohort (p=0.0089). The average length of hospital stay was 9.1 days vs. 8.4 days in PLWH versus the non-HIV group (p=0.4493). More patients were discharged to a nursing home in the non-HIV group vs. PLWH (37.8% vs. 14.3%, p=0.0001). Conclusion Hospitalized patients with COVID-19 and HIV had a higher in-hospital mortality compared to those without HIV during the first COVID wave in New York City. Disclosures All Authors: No reported disclosures


2019 ◽  
Vol 63 (5) ◽  
Author(s):  
Matthew Geriak ◽  
Fadi Haddad ◽  
Khulood Rizvi ◽  
Warren Rose ◽  
Ravina Kullar ◽  
...  

ABSTRACT Vancomycin (VAN) and daptomycin (DAP) are approved as a monotherapy for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. A regimen of daptomycin plus ceftaroline (DAP+CPT) has shown promise in published case series of MRSA salvage therapy, but no comparative data exist to compare up-front DAP+CPT head-to-head therapy versus standard monotherapy as an initial treatment. In a pilot study, we evaluated 40 adult patients who were randomized to receive 6 to 8 mg/kg of body weight per day of DAP and 600 mg intravenous (i.v.) CPT every 8 h (q8h) (n = 17) or standard monotherapy (n = 23) with vancomycin (VAN; dosed to achieve serum trough concentrations of 15 to 20 mg/liter; n = 21) or 6 to 8 mg/kg/day DAP (n = 2). Serum drawn on the first day of bacteremia was sent to a reference laboratory post hoc for measurement of interleukin-10 (IL-10) concentrations and correlation to in-hospital mortality. Sources of bacteremia, median Pitt bacteremia scores, Charlson comorbidity indices, and median IL-10 serum concentrations were similar in both groups. Although the study was initially designed to examine bacteremia duration, we observed an unanticipated in-hospital mortality difference of 0% (0/17) for combination therapy and 26% (6/23) for monotherapy (P = 0.029), causing us to halt the study. Among patients with an IL-10 concentration of >5 pg/ml, 0% (0/14) died in the DAP+CPT group versus 26% (5/19) in the monotherapy group (P = 0.057). Here, we share the full results of this preliminary (but aborted) assessment of early DAP+CPT therapy versus standard monotherapy in MRSA bacteremia, hoping to encourage a more definitive clinical trial of its potential benefits against this leading cause of infection-associated mortality. (The clinical study discussed in this paper has been registered at ClinicalTrials.gov under identifier NCT02660346.)


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jenna R. Adalbert ◽  
Karan Varshney ◽  
Rachel Tobin ◽  
Rafael Pajaro

Abstract Background Endemic to the hospital environment, Staphylococcus aureus (S. aureus) is a leading bacterial pathogen that causes deadly infections such as bacteremia and endocarditis. In past viral pandemics, it has been the principal cause of secondary bacterial infections, significantly increasing patient mortality rates. Our world now combats the rapid spread of COVID-19, leading to a pandemic with a death toll greatly surpassing those of many past pandemics. However, the impact of co-infection with S. aureus remains unclear. Therefore, we aimed to perform a high-quality scoping review of the literature to synthesize the existing evidence on the clinical outcomes of COVID-19 and S. aureus co-infection. Methods A scoping review of the literature was conducted in PubMed, Scopus, Ovid MEDLINE, CINAHL, ScienceDirect, medRxiv, and the WHO COVID-19 database using a combination of terms. Articles that were in English, included patients infected with both COVID-19 and S. aureus, and provided a description of clinical outcomes for patients were eligible. From these articles, the following data were extracted: type of staphylococcal species, onset of co-infection, patient sex, age, symptoms, hospital interventions, and clinical outcomes. Quality assessments of final studies were also conducted using the Joanna Briggs Institute’s critical appraisal tools. Results Searches generated a total of 1922 publications, and 28 articles were eligible for the final analysis. Of the 115 co-infected patients, there were a total of 71 deaths (61.7%) and 41 discharges (35.7%), with 62 patients (53.9%) requiring ICU admission. Patients were infected with methicillin-sensitive and methicillin-resistant strains of S. aureus, with the majority (76.5%) acquiring co-infection with S. aureus following hospital admission for COVID-19. Aside from antibiotics, the most commonly reported hospital interventions were intubation with mechanical ventilation (74.8 %), central venous catheter (19.1 %), and corticosteroids (13.0 %). Conclusions Given the mortality rates reported thus far for patients co-infected with S. aureus and COVID-19, COVID-19 vaccination and outpatient treatment may be key initiatives for reducing hospital admission and S. aureus co-infection risk. Physician vigilance is recommended during COVID-19 interventions that may increase the risk of bacterial co-infection with pathogens, such as S. aureus, as the medical community’s understanding of these infection processes continues to evolve.


2017 ◽  
Vol 59 (3) ◽  
pp. 275-284 ◽  
Author(s):  
Min Gyung Kim ◽  
Hyunjoo Yang ◽  
Anna S. Mattila

New York City launched a restaurant sanitation letter grade system in 2010. We evaluate the impact of customer loyalty on restaurant revisit intentions after exposure to a sanitation grade alone, and after exposure to a sanitation grade plus narrative information about sanitation violations (e.g., presence of rats). We use a 2 (loyalty: high or low) × 4 (sanitation grade: A, B, C, or pending) between-subjects full factorial design to test the hypotheses using data from 547 participants recruited from Amazon MTurk who reside in the New York City area. Our study yields three findings. First, loyal customers exhibit higher intentions to revisit restaurants than non-loyal customers, regardless of sanitation letter grades. Second, the difference in revisit intentions between loyal and non-loyal customers is higher when sanitation grades are poorer. Finally, loyal customers are less sensitive to narrative information about sanitation violations.


2013 ◽  
Vol 48 (3) ◽  
pp. 979-1000 ◽  
Author(s):  
Brian C. McTier ◽  
Yiuman Tse ◽  
John K. Wald

AbstractWe examine the impact of influenza on stock markets. For the United States, a higher incidence of flu is associated with decreased trading, decreased volatility, decreased returns, and higher bid-ask spreads. Consistent with the flu affecting institutional investors and market makers, the decrease in trading activity and volatility is primarily driven by the incidence of influenza in the greater New York City area. However, the effect of the flu on bid-ask spreads and returns is related to the incidence of flu nationally. International data confirm our findings of a decrease in trading activity and returns when flu incidence is high.


2021 ◽  
Vol 56 (S2) ◽  
pp. 41-42
Author(s):  
Sanjay Pinto ◽  
Madeline Sterling ◽  
Faith Wiggins ◽  
Rebecca Hall ◽  
Chenjuan Ma

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