3.6% of Hospitalised Covid-19 Patients Had Bacterial, Fungal
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As India continues to see a rise in black fungus cases, an ICMR study revealed that at least 3.6% of hospitalised Covid-19 patients were affected with secondary bacterial and fungal infections during the first wave of the pandemic. However, the hospitals did not report cases of the fungal infection mucormycosis.

The mortality rate in these patients increased to 56.7% as against 10.6% among hospitalised patients in the ten hospitals from where data was collected, said a statement by the ICMR. In one of the hospitals, the mortality rate was as high as 78.9%, the data releaved. The indication of the infection in the patients began two days after their hospitalisation and most of the samples tested showed it was hospital-based infection, said an ICMR scientist.

Most secondary infections, 78% of them, were acquired at the hospital. The most common pathogens causing the infection were Klebsiella pneumonia and Acinetobacter baumannii. Both the infections are very difficult to treat because they have acquired lot of resistant genes. Hospitals must invest in infection control and rationalise antimicrobial prescriptions.

The ICMR study also cautioned against the increase in antimicrobial resistance in the coming years due to excessive use of stronger medicines. Around 74.4% of the total antimicrobials prescribed in the hospitals were from the Watch and Reserve category of the World Health Organization (WHO). However, no guidelines on the rational use of antimicrobial in Covid-19 patients were clarified by ICMR in its study.

“Around 47% of the infections were found to be multi-drug resistant; but more than 74% of the antimicrobials prescribed were from the Watch and Reserve category. And, the ten hospitals from where we have collected data are in the ICMR network; they have been trained in infection control and antimicrobial stewardship. We can only imagine what is happening in other hospitals," said a doctor.

These hospitals are backed by good lab facilities and many of these antibiotics should be prescribed only after the culture test comes positive. However, a very low number of samples were collected for microbial culture.