Falcone et al reported risk factors for nosocomial infection in patients hospitalized with COVID-19. The authors are from the University of Pisa in Italy.
Patient selection: hospitalized patient with COVID-19
Outcome: nosocomial bacterial or fungal infection (referred to as "superinfection"), with onset >= 48 hours after admission
Factors contributing to nosocomial infection:
(1) long hospital stay
(2) therapy with broad-spectrum antibiotics
(3) breaks in infection control protocols
(4) immunomodulatory therapy (corticosteroids; IL-6 or JAK inhibitors)
Predictors of nosocomial infection from multivariate analysis:
(1) intestinal colonization by carbapenem resistant Enterobacteriaceae (OR 16)
(2) invasive mechanical ventilation (OR 5.6)
(3) therapy with IL-6 or JAK inhibitors (OR 5.1)
(4) serum C-reactive protein on admission > 7 mg/dL (70 mg/L; OR 3.6)
(5) therapy with piperacillin/tazobactam (OR 2.9)
The course of the infection may be complicated if the nosocomial infection is due to a multi-drug resistant organism.
