Table 2.
Diagnostic Testing, Coinfection, and Antibacterial Use in Hospitalized Patients With Coronavirus Disease 2019 (COVID-19)
| Values | |
|---|---|
| Cultures obtained within first 3 days of hospitalization | |
| Blood or respiratory culture obtained | 1095 (64.2) |
| Blood culture | 1063 (62.3) |
| Respiratory culture | 131 (7.7) |
| Nonculture testing performed | 934 (54.8) |
| Respiratory PCR test | 783 (45.9) |
| Urine legionella antigen | 413 (24.2) |
| Urine pneumococcal antigen | 304 (17.8) |
| Had a community-onset bacterial coinfectiona | 59 (3.5) |
| Positive blood or respiratory culture | 55 (3.2) |
| Positive blood culture | 31 (1.8) |
| Positive respiratory culture | 25 (1.5) |
| Had a community-onset viral coinfectionb | 9 (0.5) |
| Influenza A or B | 1 (0.1) |
| Other viral pathogen | 8 (0.5) |
| Empiric antibacterial therapyc | 965 (56.6) |
| Community-acquired empiric coverage onlyd | 612 (35.9) |
| Ampicillin/sulbactam | 41 (2.4) |
| Cefotaxime | 5 (0.3) |
| Ceftriaxone | 663 (38.9) |
| Moxifloxacin | 4 (0.2) |
| Levofloxacin | 20 (1.2) |
| Ceftaroline | 1 (0.1) |
| Empiric anti-MRSA therapye | 249 (14.6) |
| Vancomycin | 235 (13.8) |
| Empiric anti-pseudomonal therapyf | 254 (14.9) |
| Cefepime | 177 (10.4) |
| Piperacillin/ tazobactam | 72 (4.2) |
| Empiric anti-MRSA and anti-pseudomonal therapye,f | 184 (10.8) |
| Turnaround time for COVID-19 PCR test, median (IQR), d | 1 (0–2) |
| Length of hospital stay, median (IQR), d | 5 (3–9) |
Data are presented as n (%) unless otherwise indicated; N = 1705.
Abbreviations: COVID-19, coronavirus disease 2019; IQR, interquartile range; MRSA, methicillin-resistant Staphylococcus aureus; PCR, polymerase chain reaction.
aCommunity-onset bacterial coinfection included any positive blood or respiratory culture or microbiological test obtained in the first 3 days of hospitalization (contaminants excluded).
bCommunity-onset viral coinfection included any viruses identified on a respiratory PCR obtained in the first 3 days of hospitalization.
cEmpiric antibacterial therapy was defined as any intravenous or oral antibacterial therapy prescribed on day 1 or 2 of hospitalization. Does not include patients who received azithromycin monotherapy. May add up to more than 100% as patients may be in multiple rows.
dIncludes patients who received antibacterials recommended for empiric community-acquired pneumonia (CAP) treatment in 2019 CAP guidelines [17] (ie, ampicillin/sulbactam, cefotaxime, ceftriaxone, moxifloxacin, levofloxacin, ceftaroline) and did not receive empiric anti-MRSA or anti-pseudomonal coverage.
eAnti-MRSA antibacterials include vancomycin, linezolid, sulfamethoxazole/trimethoprim, or clindamycin.
fAnti-pseudomonal antibacterials include piperacillin/tazobactam, aminoglycosides, ceftazidime, aztreonam, meropenem, imipenem, ceftolozane/tazobactam, polymixin B, colistin, ciprofloxacin, cefepime, ceftazadime-avibactam, or meropenem-vaborbactam.