Increased surge of secondary bacterial infections leading to sepsis among COVID 19 patients in a tertiary care centre in South India

Secondary bloodstream infections (BSIs) remain one of the frequent and life-threatening complications among COVID 19 infected patients. The present study has been undertaken to determine the prevalence of secondary BSIs in patients with COVID-19 This is an observational case control study, conducted between May2020 and April 2021 in a tertiary care centre in South India. The study population were further divided into three groups—one case group (COVID group), and two control (non-COVID group 2020-21 and 2019-20). Blood cultures sent from a suspected care of secondary blood stream infection were processed and outcomes like blood culture positivity rate, clinically relevant growth, contaminant rate and multidrug resistant organism rate were compared between the COVID group and non-COVID control groups. Among the COVID group 307 (17%) of the episodes were found to show clinically relevant growth compared with 3570 (15.4%) in control group 2020-21 (p<0.05) and 3974(12%) in control group 2019-20 (p<0.001). In all the 3 groups, gram negative bacterial infections were found to be the majority with 50% (COVID group), 57% and 58% (non-COVID groups). Among all the MDR organisms isolated from the COVID group of patients, carbapenem resistant contributes about 88%. In COVID-19 patients, the prevalence of secondary bacterial sepsis due to multidrug resistant organisms are higher when compared to non-COVID patients. Non-adherence to strict infection control practices are the possible causes for the higher infection rate among the COVID group of patients.