Secondary bacterial infections in post-COVID-19 mucormycosis cases: a retrospective study at Imam Khomeini Hospital Complex, March 2020-April 2021

Mohsen Meidani; Sepideh Zahak Miandoab; Amir Salami; Sajedeh Jadidi; Marjan Sohrab; Parvaneh  Ebrahimi Alavijeh; Sara  Ghaderkhani; Hamid Emadi Koochak; Arezoo Salami Khaneshan

doi:10.18502/ijm.v16i3.15759

Mohsen Meidani Department of Infectious Disease and Tropical Medicine, Tehran University of Medical Sciences, Tehran, Iran
Sepideh Zahak Miandoab Department of Infectious Disease and Tropical Medicine, Tehran University of Medical Sciences, Tehran, Iran
Amir Salami Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Sajedeh Jadidi Department of Urology, Shahid Beheshti University of Medical Sciences, Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Tehran, Iran
Marjan Sohrab Department of Infectious Disease and Tropical Medicine, Tehran University of Medical Sciences, Tehran, Iran
Parvaneh Ebrahimi Alavijeh Department of Infectious Disease and Tropical Medicine, Tehran University of Medical Sciences, Tehran, Iran
Sara Ghaderkhani Department of Infectious Disease and Tropical Medicine, Tehran University of Medical Sciences, Tehran, Iran
Hamid Emadi Koochak Department of Infectious Disease and Tropical Medicine, Tehran University of Medical Sciences, Tehran, Iran
Arezoo Salami Khaneshan Department of Infectious Disease and Tropical Medicine, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/ijm.v16i3.15759

Keywords: Bacterial infection; Mucormycosis; COVID-19; Acinetobacter baumannii; Klebsiella pneumonia; Escherichia coli

Abstract

Background and Objectives: To explore the prevalence and characteristics of secondary bacterial infections among patients suffering from mucormycosis following COVID-19 infection.

Materials and Methods: We conducted a cross-sectional, retrospective analysis from March 2020 to April 2022 at Imam Khomeini Hospital Complex in Tehran. The study included patients with histopathologically confirmed mucormycosis and documented secondary bacterial infections. We extracted and analyzed data from hospital records using SPSS software, version 26.

Results: The study comprised 27 patients, with a predominance of females (70.4%) and an average age of 56 years. The majority of these patients (63%) had pre-existing diabetes mellitus. The severity of their COVID-19 infections varied. Treat- ment regimens included immunosuppressive drugs and antibiotics. Rhinocerebral mucormycosis was the most common form observed. The predominant secondary infections involved the urinary tract, respiratory system, bloodstream (bacteremia), and soft tissues, with resistant strains of Acinetobacter baumannii, Escherichia coli, and Klebsiella pneumoniae being the most frequently identified microorganisms. Notably, cases of bacteremia and pneumonia exhibited a higher mortality rate. Ultimately, 55.6% of patients were discharged, while 44.4% succumbed to their infections.

Conclusion: Patients recovering from COVID-19 with mucormycosis are significantly susceptible to secondary bacterial infections, particularly those with diabetes mellitus or those undergoing immunosuppressive therapy. Such infections com- pound the morbidity and mortality risks in this vulnerable patient cohort.