Gajic, I. (55428924700)I. (55428924700)GajicJovicevic, M. (57223044336)M. (57223044336)JovicevicPopadic, V. (57223264452)V. (57223264452)PopadicTrudic, A. (56748072700)A. (56748072700)TrudicKabic, J. (57215669275)J. (57215669275)KabicKekic, D. (36696225200)D. (36696225200)KekicIlic, A. (59430649200)A. (59430649200)IlicKlasnja, S. (57222576460)S. (57222576460)KlasnjaHadnadjev, M. (55362426300)M. (55362426300)HadnadjevPopadic, D.J. (58260434300)D.J. (58260434300)PopadicAndrijevic, A. (57225223464)A. (57225223464)AndrijevicProkic, A. (58259671600)A. (58259671600)ProkicTomasevic, R. (6603547250)R. (6603547250)TomasevicRanin, L. (6602522806)L. (6602522806)RaninTodorovic, Z. (7004371236)Z. (7004371236)TodorovicZdravkovic, M. (24924016800)M. (24924016800)ZdravkovicOpavski, N. (6507364674)N. (6507364674)Opavski2025-06-122025-06-122023https://doi.org/10.1016/j.jhin.2023.04.013https://www.scopus.com/inward/record.uri?eid=2-s2.0-85159584277&doi=10.1016%2fj.jhin.2023.04.013&partnerID=40&md5=ea6590135ca9dd7a9ba2a0afad1c3549https://remedy.med.bg.ac.rs/handle/123456789/2676Introduction: We evaluated the prevalence, aetiologies and antibiotic resistance patterns of bacterial infections in hospitalized patients with laboratory-confirmed SARS-CoV-2. We also investigated comorbidities, risk factors and the mortality rate in COVID-19 patients with bacterial infections. Methods: This retrospective observational study evaluated medical records of 7249 randomly selected patients with COVID-19 admitted to three clinical centres between 1st January 2021 and 16th February 2022. A total of 6478 COVID-19 patients met the eligibility criteria for analysis. Results: The mean age of the patients with SARS-CoV-2 and bacterial infections was 68.6 ± 15.5 years (range: 24–94 years). The majority of patients (68.7%) were older than 65 years. The prevalence of bacterial infections among hospitalized COVID-19 patients was 12.9%, most of them being hospital-acquired (11.5%). Bloodstream (37.7%) and respiratory tract infections (25.6%) were the most common bacterial infections. Klebsiella pneumoniae and Acinetobacter baumannii caused 25.2% and 23.6% of all bacterial infections, respectively. Carbapenem-resistance in Enterobacterales, A. baumannii and Pseudomonas aeruginosa were 71.3%, 93.8% and 69.1%, respectively. Age >60 years and infections caused by ≥3 pathogens were significantly more prevalent among deceased patients compared with survivors (P<0.05). Furthermore, 95% of patients who were intubated developed ventilator-associated pneumonia. The overall in-hospital mortality rate of patients with SARS-CoV-2 and bacterial infections was 51.6%, while 91.7% of patients who required invasive mechanical ventilation died. Conclusions: Our results reveal a striking association between healthcare-associated bacterial infections as an important complication of COVID-19 and fatal outcomes. © 2023 The AuthorsAntimicrobial resistanceBacterial infectionsCOVID-19SARS-CoV-2