Bacterial Co-Infections in Patients with COVID-19 and Their Resistance Profiles: A Study from Southern Libya

Bacterial co-infections in COVID-19 patients are a significant concern due to their impact on patient outcomes, contributing to high morbidity and mortality. This study investigates the prevalence and antimi¬crobial resistance of bacterial isolates from COVID-19 patients at Sebha Medical Center in Southern Libya. Additionally, the role of age, sex, and antibiotic therapy in clinical outcomes was analyzed. A total of 70 sputum samples were collected and analyzed for bacterial growth. Antimicrobial susceptibility was tested using the Kirby-Bauer disk diffusion method, and phenotypic resistance tests were employed to identify specific resistance mechanisms. The results revealed that 27.14% of the samples tested positive for bacterial growth, with Acineto¬bacter baumannii being the most frequently isolated species (73.68%), followed by Klebsiella pneumo¬niae (15.79%) and Pseudomonas spp. (10.53%). Furthermore, the average age of patients with bacterial co-infections (64 years) was higher compared to those without co-infections (60 years). The study also found that bacterial co-infections were associated with longer hospital stays. Resistance to ceftriaxone (30 μg) was observed in 89.47% of isolates. Further phenotypic testing confirmed the production of met¬allo-β-lactamases (MβL) in 36.84%, carbapenemases (using the Modified Hodge Test, MHT) in 31.57%, and extended-spectrum β-lactamases (ESBL) in 15.78%. No isolates tested positive for AmpC β-lactamase production. These findings highlight the critical need for effective management of COVID-19 patients to improve outcomes for bacterial co-infections, combat antibiotic resistance, and reduce hospital length of stay.