Coinfección/sobreinfección fúngica en pacientes con COVID-19 en un hospital de tercer nivel en México

Eduardo García-Salazar, Sandra Benavidez-López, Alexandro Bonifaz, Emma Alejandra Hernández-Mendoza, Xóchitl Ramírez-Magaña, María del Rocío Reyes-Montes, Esperanza Duarte-Escalante, Gustavo Acosta-Altamirano, María Guadalupe Frías-De-León , .

Palabras clave: Micosis, COVID-19, Candidemia, Infección del tracto urinario, Aspergilosis

Resumen

Introduction. Data on the prevalence of fungal coinfections/superinfections in patients with COVID-19 are limited.
Objective. To describe the prevalence of fungal coinfections/superinfections in patients with COVID-19, as well as risk factors and demographic, clinical, and microbiological characteristics in a tertiary hospital in Mexico.
Material and methods. Patients with a confirmed COVID-19 diagnosis and a confirmed fungal infection hospitalized in the ICU from March 2020–December 2021 were included. Data on age, sex, comorbidities, hospital length of stay (days), laboratory (ferritin) and microbiological results, treatment for COVID-19, antifungal therapy, and outcome were obtained from the clinical record.
Results. 11/740 patients met the inclusion criteria. The coinfection and superinfection rates were 0.3% and 1.2%, respectively. The most affected population was male adults. The coinfections/superinfections diagnosed were candiduria and candidemia, caused by Candida albicans, C. tropicalis, C. glabrata, C. lusitaniae, and Kluyveromyces marxianus (C. kefyr). In addition, tracheobronchitis due to Aspergillus fumigatus was found. The most used antifungals were fluconazole and caspofungin. The lethality in patients with fungal coinfections and superinfections was 50% and 22%, respectively. The length of hospital stay was 11-65 days. Eight patients required mechanical ventilation and six received corticosteroids. The main comorbidity was diabetes mellitus (81.8%).
Conclusions. The rate of fungal coinfections/superinfections in COVID-19 patients was low, but the lethality found urges for routine fungal screening in patients with severe COVID-19 to timely detect fungal infections that may further compromise the patient's life.

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  • Eduardo García-Salazar Hospital Regional de Alta Especialidad de Ixtapaluca, Pueblo de Zoquiapan, Ixtapaluca, México https://orcid.org/0000-0002-8900-9380
  • Sandra Benavidez-López Hospital Regional de Alta Especialidad de Ixtapaluca, Pueblo de Zoquiapan, Ixtapaluca, México https://orcid.org/0009-0008-0766-843X
  • Alexandro Bonifaz Laboratorio de Micología, Servicio de Dermatología, Hospital General de México "Dr. Eduardo Liceaga", Ciudad de México, México https://orcid.org/0000-0003-2045-3317

    Doctor con amplia experiencia en micología clínica, reconocido internacionalmente

  • Emma Alejandra Hernández-Mendoza Hospital Regional de Alta Especialidad de Ixtapaluca, Pueblo de Zoquiapan, Ixtapaluca, México https://orcid.org/0009-0004-0909-1938
  • Xóchitl Ramírez-Magaña Hospital Regional de Alta Especialidad de IxtapalucaHospital Regional de Alta Especialidad de Ixtapaluca, Pueblo de Zoquiapan, Ixtapaluca, México https://orcid.org/0009-0009-7348-6615
  • María del Rocío Reyes-Montes Laboratorio de Micología, Servicio de Dermatología, Hospital General de México "Dr. Eduardo Liceaga", Ciudad de México, México https://orcid.org/0000-0002-3866-9995
  • Esperanza Duarte-Escalante Laboratorio de Micología, Servicio de Dermatología, Hospital General de México "Dr. Eduardo Liceaga", Ciudad de México, México https://orcid.org/0000-0002-6315-7860

    Doctora en Ciencias Biológicas con amplia experiencia en el campo de la investigación en Micología

  • Gustavo Acosta-Altamirano Hospital Regional de Alta Especialidad de Ixtapaluca, Pueblo de Zoquiapan, Ixtapaluca, México https://orcid.org/0000-0002-5623-6683

    Médico especialista en Inmunología, designado a la atención de pacientes COVID-19 durante la pandemia

  • María Guadalupe Frías-De-León Hospital Regional de Alta Especialidad de Ixtapaluca, Pueblo de Zoquiapan, Ixtapaluca, México
Cómo citar
1.
García-Salazar E, Benavidez-López S, Bonifaz A, Hernández-Mendoza EA, Ramírez-Magaña X, Reyes-Montes M del R, et al. Coinfección/sobreinfección fúngica en pacientes con COVID-19 en un hospital de tercer nivel en México. biomedica [Internet]. 3 de abril de 2024 [citado 19 de mayo de 2024];44(3). Disponible en: https://revistabiomedica.org/index.php/biomedica/article/view/7251

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Publicado
2024-04-03

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