The following is a summary of “Bacteriuria and antibiotic use during the third wave of COVID-19 intensive care in Sweden,” published in the November 2024 issue of Infectious Disease by Karlsson et al.
Indwelling catheter use in the intensive care unit (ICU) is linked with a high prevalence of urinary tract infections (UTIs).
Researchers conducted a retrospective study to analyze the association between antibiotic use and bacterial colonisation among patients admitted to the ICU during the third wave of the COVID-19 pandemic.
They analyzed 109 urine samples from patients with COVID-19 along with transurethral catheterization to determine bacterial prevalence. Bacterial species were determined by using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry. The microbiological findings were integrated with daily clinical data and compared across the first and second waves of COVID-19.
The results showed that patients in wave 3 had better outcomes than those in waves 1 and 2, along with reduced antibiotic usage. Staphylococcus was identified as the dominant bacterium and early urinary tract colonizer, likely due to the reduced antibiotic intervention. Length of stay (LOS) correlated specifically with enteric pathogens, while antibiotic treatment was linked to colonization by certain uropathogens. Conversely, the lack of antimicrobial therapy was associated with rapid colonization by skin flora. Polymicrobial colonization was frequently observed, primarily involving Gram-positive bacteria.
Investigators concluded the patients admitted to ICU have complex bacteria, emphasize the need for targeted surveillance and tailored antibiotic strategies to reduce UTI risk and improved outcomes.
Source: tandfonline.com/doi/full/10.1080/23744235.2024.2423884
