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The impact of Acinetobacter baumannii infections in COVID-19 patients in hospital intensive care units
* 1, 2, 3 , 4 , 5 , 6 , 7 , 8 , 9
1  University of Bucharest, Faculty of Biology, Microbiology-Immunology Department
2  The Research Institute of the University of Bucharest, Bucharest, Romania
3  Institute of Biology, Bucharest of Romanian Academy, 296 Splaiul Independentei, 060031 Bucharest, Romania
4  Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, Bucharest, Romania
5  Immunology Department, “Victor Babes” National Institute of Pathology, Bucharest, Romania
6  Department of Genetics, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania
7  Institute of Biology of Romanian Academy, 060031 Bucharest, Romania
8  Faculty of Medicine, “Titu Maiorescu” University, Bucharest, Romania
9  AMS Genetic Lab, Turturelelor 62, Bucharest, Romania
Academic Editor: Nico Jehmlich


Since the end of 2019, the Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread globally, affecting people worldwide. Patients with severe COVID-19 require intensive care unit (ICU) admission for acute respiratory failure; over 10% need noninvasive and invasive mechanical ventilation. Acute respiratory distress syndrome (ARDS) severity and ventilation management determine a negative outcome and a 90-day mortality of 31%. During the COVID-19 pandemic, the impact of superinfections in ICUs has progressively increased, especially carbapenem-resistant Acinetobacter baumannii (CRAB). Infections caused by A. baumannii represent a significant concern for COVID-19 patients. The data about superinfections complicating COVID-19 are scant. A significant proportion of these patients are treated with empiric broad-spectrum antibiotic therapy, which increases the risk of developing infections caused by CRAB. Finally, drugs targeting cytokines, such as IL-1 and IL-6, might also increase the risk of superinfections in patients with COVID-19. Appropriate prescription and optimized use of antimicrobials according to the principles of antimicrobial stewardship, quality diagnosis, and aggressive infection control measures may help prevent CRAB infections during this pandemic. Recommended guidelines for antimicrobial stewardship in COVID-19 patient treatment are discussed regarding the minimization of empiric broad-spectrum antibiotic use. In this mini-review, we will present the impact of CRAB infections on the outcome of patients with COVID-19 requiring ICU admission.

Keywords: COVID-19; antibiotic resistance; Acinetobacter baumannii; intensive care units; carbapenems;