Abstract

Background: Analysis of the antibiotic resistance and clinical features of clinical bacterial and fungi isolates from the lower respiratory tract of patients infected with COVID-19.

Methods: Collected the qualified lower respiratory tract 397 strains of patients infected with COVID-19 between 10 December 2022 and 10 January 2023.The isolated strains were identified and tested for antimicrobial susceptibility. Colloidal gold enzyme type assays for carbapenem-resistant Klebsiella pneumoniae; analyzed procalcitonin interleukin 6,C-reactive protein and neutrophils. The Whonet 5.6 software was used to analyse the results.

Results: A total of 123 strains were isolated, of which 97 were bacterial and 26 were fungal, respectiveley. Pseudomonas aeruginosa strains showed lower resistance to cefoperazone/sulbactam and imipenem（22% and 6. 5%), the resistance rates of fungi to fluconazole and voriconazole were 7.7% and 3.8% respectively, the isolation rate of carbapenem-resistant Klebsiella pneumonia is 12% (3/25), the enzyme type is all KPC-2. The drug resistance rate of Acinetobacter baumannii to most antibiotics is more than 50%, still, the drug resistance rate to cefoperazone/sulbactam is 27%, which also maintains a lower drug resistance level.No staphylococcal strains were found resistant to vancomycin, ceftaroline, and Linezolid. There are 98 strains isolated from the people, especially 80 to 96. Clinical data showed that at least one index of PCT, IL-6, CRP, or neutrophil increased in 120 patients.

Conclusion: There is an excellent possibility that the elderly infected with COVID-19 may suffer from secondary bacterial and fungal infections. Improve surveillance and laboratory testing for inflammatory factors for a comprehensive assessment.

Keywords: Lower respiratory tract; COVID-19; Resistance analysis; Novel coronavirus