Bacterial co-infection in patients with SARS-CoV-2 in the Kingdom of Bahrain

Table 4 Comparison between the community and hospital acquired infections and their microbiologic profile from coronavirus disease 2019 confirmed patients (total isolates 472)

Character					HA infection	CA infection	P value
Patient number (total 261) 22 patients has both HA and CA					185 (70.8%)	98 (37.5%)	< 0.0001
Age					60.8 ± 16.8	54. ± 20.6	< 0.01
Male: Female					0.85	0.80	> 0.05
Bharani					137 (74%)	71 (72.4%)	> 0.05
Death					102 (55%)	23 (23.5%)	< 0.0001
Gram negative isolates (164)	Klebsiella pneumoniae			Total	30	9
				ESBL	11	0
				CRE	15	2
	Acinetobacter baumannii (MDR)				29	7
	Pseudomonas aeruginosa			Total	28	10
				CRP	6	2
				MDR	2	2
	Escherichia coli			Total	13	15
				ESBL	6	6
				CRE	5	2
	Stenotrophomonas maltophilia				11	1
	Enterobacter cloacae			Total	2	0
				CRE	1	0
	Others				8	1
	Total number of the G-ve isolates (164)				121 (73.8%)	43 (26.2%)	< 0.0001
	Number of G-ve resistant Strains				75 (62%)	21(48.8%)	> 0.05
	% from total Resistant strains (96)				78.1%	21.9%	< 0.0001
Gram positive isolates (164)	Coagulase negative Staphylococci (CoNS)	Staphylococcus epidermidis		Total	19	6
				MRCoNS	18	4
		Staphylococcus haemolyticus		MRCoNS	14	4
		Staphylococcus hominis		Total	12	19
				MRCoNS	6	13
		Staphylococcus capitis		Total	5	5
				MRCoNS	5	0
		Staphylococcus pettenkoferi		MRCoNS	1	0
		Total CoNS		Total	41 (40.6%)	31 (49.2%)	> 0.05
				MRCoNS	37 (90%)	21 (67.7%)	< 0.05
	Enterococcus faecium			Total	17	7
				VRE	2	1
				HLGR	1	0
	Enterococcus faecalis			Total	16	4
				HLGR	1	0
	Staphylococcus aureus			Total	8	8
				MRSA	3	5
	Others				9	10
	Total number of the G + ve isolates (164)				101 (61.6%)	63 (38.4%)	< 0.0001
	Number of G + ve resistant strains				51 (50.5%)	27 (42.9%)	> 0.05
	% from total Resistant strains (78)				65.4%	34.6%	< 0.0001
Fungal isolates (144)			Candida galabrata		11	0
			Candida albicans		7	0
			Candida tropicalis		9	0
			Candida parapsilosis		3	0
			Aspergillus fumigatus		3	0
			Aspergillus niger		3	0
			Total		36	0
	Candida species				95	13
	Total fungal isolates (144)				131 (91%)	13 (9%)	< 0.0001
Total microbial isolates (472)					353 (74.8%)	119 (25.2%)	< 0.0001
Total number of resistant bacterial strains					126 (35.7%)	48 (40.3%)	> 0.05
Percentage from total resistant bacterial strains (174)					72.4%	27.6%	< 0.0001

CA: Community Acquired; CRE: Carbapenem-resistant Enterobacteriaceae; ESBL: Extended spectrum beta-lactamase; HA: Hospital acquired; HLGR: High level aminoglycoside resistance; MDR: Multidrug-resistant; MRCoNS: Methicillin-resistant coagulase-negative Staphylococci; MRSA: Methicillin-resistant Staphylococcus aureus; VRE: Vancomycin-resistant enterococci; Other gram-negative bacteria: Citrobacter freundii, Salmonella species, Pantoea species, Proteus mirabilis, Serratia marcescens, Elizabethkingia meningoseptica; Other gram-positive bacteria: Streptococcus agalactiae (Strep. Group B), Corynebacterium afermentans, Bacillus licheniformis, Leuconostoc mesenteroides, Staphylococcus caprae, Staphylococcus lugdunensis, Staphylococcus warneri, Streptococcus parasanguinis, Gemella sanguinis, Micrococcus luteus, Propionibacterium acnes, Rhodococcus erythropolis, Aerococcus viridans, Staphylococcus gallinarum.