@article{MRA, author = {BabySailaja K and Renuka MK and Rathish Manimohan and Prasanth NVSN}, title = { Prevalence of secondary infections, antimicrobial susceptibility and predictors for mortality among critically ill COVID 19 patients admitted to an Intensive Care Unit in India}, journal = {Medical Research Archives}, volume = {12}, number = {8}, year = {2024}, keywords = {}, abstract = {Background: Critically ill COVID 19 patients requiring intensive care unit admission are at an increased risk of secondary infections owing to the need for invasive or non invasive oxygen therapy, prolonged indwelling catheters and long stay in intensive care unit. Secondary infections can further alter the clinical course and outcomes of these patients Aims: In this study we aimed to investigate the prevalence, characteristics and factors associated with mortality in critically ill COVID 19 patients with secondary infections. Methods: This was a single centre retrospective cohort study of adult critically ill COVID 19 patients admitted to the intensive care unit of a tertiary care hospital in India during one year period from May 2020 to April 2021. Results: Among the 285 patients admitted to the intensive care unit 124 patients were identified with secondary infection. Out of the 250 isolates, 72.3% were gram negative bacilli with highest number of isolates recognised from blood (n=112, 44.8%). The most common organisms identified in our cohort were Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, Candida species and Enterococcus faecalis. Anti-microbial resistance was detected in 58.8% (n=147) of the isolates and majority of the patients received Carbapenem and Polymyxin. Patients with secondary infections were at increased risk of developing septic shock, acute kidney injury and also experienced higher mortality (50%, P-value <0.001). In our study cohort, increasing cumulative dose of steroids [OR 1.002, 95% CI: 1.001-1.004)] and increasing length of intensive care unit stay [OR 1.071, (95% CI: 1.030-1.113)] were found to be predictive of mortality among patients with secondary infection.    Conclusion: Secondary infections were high among the critically ill COVID 19 patients with high antimicrobial resistance and lead to high mortality. This being a single centre retrospective study, prospective evaluation with proper anti-microbial stewardship is needed for more precise results.}, issn = {2375-1924}, doi = {10.18103/mra.v12i8.5593}, url = {https://esmed.org/MRA/mra/article/view/5593} }