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Secondary unculturable bacteria associated with Sars-Cov-2: More information are required

1 Medical Technique Department, College of Medical Technique, The Islamic University; Department of Microbiology, Al-Shomali General Hospital, Babylon, Iraq
2 Department of Microbiology, Al-Shomali General Hospital, Babylon, Iraq

Date of Submission25-Aug-2021
Date of Decision10-Oct-2021
Date of Acceptance24-Oct-2021

Correspondence Address:
Falah Hasan Obayes AL-Khikani,
Department of Microbiology, Al-Shomali General Hospital, Babil
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mjdrdypu.mjdrdypu_698_21

How to cite this URL:
Obayes AL-Khikani FH, Kadim MM. Secondary unculturable bacteria associated with Sars-Cov-2: More information are required. Med J DY Patil Vidyapeeth [Epub ahead of print] [cited 2022 Dec 6]. Available from: https://www.mjdrdypv.org/preprintarticle.asp?id=345910

Dear Sir,

Coronavirus disease 2019 (COVID-19) is a zoonotic infection caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with the extreme acute respiratory syndrome. Coronavirus is a zoonotic infection with a positive polarity RNA envelope that belongs to the Coronaviridae family. There are four recognized genera of coronavirus, however, on January 10, 2020, a new coronavirus arose in Wuhan, China, causing a serious pulmonary outbreak. SARS-CoV-2 appears to be the third highly deadly human coronavirus to develop in the recent two decades, following SARS coronavirus and Middle East respiratory syndrome coronavirus.[1]

SARS-CoV-2 infection associated with a bacterial pathogen (combined viral and bacterial pneumonia) was described in COVID-19. Secondary bacterial pneumonia can develop after a viral respiratory illness has cleared up or during the healing period.[2]

In fatal instances, bacterial infections are more prevalent than in recovered patients. If bacterial infections are the cause of death in COVID-19, this has significant implications for patient treatment.[3]

The death rate for patients who acquired secondary infections was 56.7%, compared to 10.6% for all COVID-19 patients hospitalized. In 78% of the cases, Gram-negative bacteria were found. The most common pathogen was Klebsiella pneumoniae (29%), followed by Acinetobacter baumannii (21%), Pseudomonas aeruginosa (9.6%), and  Escherichia More Details coli (8.2%). Methicillin-resistant Staphylococcus aureus Scientific Name Search  was isolated only in 1.29%. High levels of carbapenem resistance were seen in A. baumannii (92.6%) followed by K. pneumoniae (72.8%).[4]

According to recent research, bacterial coinfection occurred in 3.1%–3.5% of COVID-19 patients at admission, with subsequent bacterial infections occurring in up to 15% of patients following hospitalization.[5]

Atypical organisms linked to COVID-19 are organisms that are difficult to grow and do not show up on a gram stain. Because antibiotics must be able to enter intracellularly to reach their intended target, they are difficult to separate and treat due to their intracellular nature. Because atypical organisms lack cell walls, such as M. pneumoniae, the most prevalent, beta-lactam antibiotics are not indicated. Antibiotic resistance, poor compliance, and an inability to take oral medicines are all factors that contribute to treatment failure. Furthermore, some individuals may have obstructive lung lesions or a misdiagnosis.

Atypical pneumonia can be contracted from a variety of causes. Mycoplasma pneumoniae which is associated with close living conditions such as at school and military barracks, legionella from stagnant water sources, Chlamydophila pneumoniae, Coxiella burnetii, and Francisella tularensis from various mammalian sources is among the most commonly identified atypical pathogens.[6]

  Conclusion Top

Secondary infections in COVID-19 patients have been linked to poor health outcomes. Nonculturable bacteria have been associated with death in COVID-19 patients, and they may require a specific antibiotic to preserve the patient's life. More research is needed to validate this issue, as there is currently little evidence available.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Al-Khikani FH. Amphotericin B as antiviral drug: Possible efficacy against COVID-19. Ann Thorac Med 2020;15:118-24.  Back to cited text no. 1
  [Full text]  
Wu CP, Adhi F, Highland K. Recognition and management of respiratory coinfection and secondary bacterial pneumonia in patients with COVID-19: Posted April 27, 2020. Cleve Clin J Med 2020;5:87.  Back to cited text no. 2
Farrell JM, Zhao CY, Tarquinio KM, Brown SP. Causes and consequences of COVID 19 associated bacterial infections. Front Microbiol 2021;12:68-71.  Back to cited text no. 3
Vijay S, Bansal N, Rao BK, Veeraraghavan B, Rodrigues C, Wattal C, et al. Secondary infections in hospitalized COVID-19 patients: Indian experience. Infect Drug Resist 2021;14:1893-903.  Back to cited text no. 4
Garcia-Vidal C, Sanjuan G, Moreno-García E, Puerta-Alcalde P, Garcia-Pouton N, Chumbita M, et al. Incidence of co-infections and super infections in hospitalized patients with COVID-19: A retrospective cohort study. Clin Microbiol Infect 2021;27:83-8.  Back to cited text no. 5
Wagner K, Springer B, Imkamp F, Opota O, Greub G, Keller PM. Detection of respiratory bacterial pathogens causing atypical pneumonia by multiplex Lightmix® RT-PCR. Int J Med Microbiol 2018;308:317-23.  Back to cited text no. 6


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