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Aim: Due to the fact that patients with COVID--19 can have a bacterial co-infection, physicians should be careful when prescribing antibiotics, with rather considering the sensitivity and resistance of these drugs than various bacteria. Therefore, the main purpose of the present study was to evaluate bacterial coinfections and antibiotic resistance in positive COVID-19 patients. Method: This descriptive cross-sectional study was performed on 450 hospitalized COVID-19 patients who were selected by simple random sampling. Blood culture (BC) and endotracheal aspirate (ETA) were performed for all COVID-19 patients participating in the study. Antibacterial susceptibility was assessed using the standard Kirby-Bauer disk diffusion method on Mueller Hinton agar for all isolated strains in accordance with the Institute of Clinical and Laboratory Standards guidelines. Finally, susceptibility of all identified bacteria to 10 types of antibiotics was assessed. Results: Based on the results of endotracheal aspirate (ETA) culture, we found that 79 (17.5%) patients had COVID-19 and bacterial co-infection. Among COVID-19 patients with bacterial co-infection, Klebsiella species had the highest frequency (21.6%), followed by Methicillin-sensitive Staphylococcus aureus (MSSA) (19%), Escherichia coli (17.7%), Methicillin-resistant Staphylococcus aureus (MRSA) (15.2%), Enterobacter species (13.9%) and Pseudomonas aeruginosa (12.6%), respectively. Based on the results of the present study, it was found that the level of antibiotic resistance for different bacteria varied from 0-100%. Conclusion: The results of the present study indicate that patients with COVID-19 are susceptible to bacterial co-infection, which leads to the conclusion that excessive use of antibiotics is an important factor in the development of antimicrobial resistance. Therefore, caution is needed in prescribing different antibiotics to patients with COVID-19. In addition, considering the SARS-CoV-2 co-infection with other pathogens, it is necessary to use an optimal treatment method for this purpose. [ABSTRACT FROM AUTHOR]

Background: Production of metallo-β-lactamase, an enzyme that hydrolyze a variety of β-lactams including carbapenems leaving little therapeutic option is increasing. To manage patients effectively, it is important to know the local prevalence of MBLs in the hospital. Present study was undertaken to determine prevalence of metallo-β-lactamase production along with the clinical profile of Acinetobacter baumannii and Pseudomonas aeruginosa. Methods: Prospective cross sectional study was carried out during December-2010 to November-2011. Relevant demographic and clinical details were collected. Acinetobacter baumannii and Pseudomonas aeruginosa were subjected to antimicrobial susceptibility testing by Kirby-bauer disc diffusion method and mini API system, (bioMerieux-France). Imipenem/meropenem resistant isolates were tested for metallo-β-lactamase production by imipenem-EDTA combined disc test. Results: 81 strains of Acinetobacter baumannii and 28 strains of Pseudomonas aeruginosa were isolated. Most common specimens from which Acinetobacter baumanni and Pseudomonas aeruginosa isolated were from respiratory tract i.e. 47 (58%) and 12 (42.9%) respectively. Majority of the strains of Acinetobacter baumannii 44 (54.3%) and Pseudomonas aeruginosa 17 (60.7%) were isolated from non critical areas. Both organisms showed high prevalence of multidrug resistance with MBLs production of 29.6% in Acinetobacter baumannii and 42.9% in Pseudomonas aeruginosa. Conclusion: Metallo-β-lactamase-mediated carbapenem resistance is a significant threat in hospitalized patients. It should be addressed with rapid detection and stringent infection control measures. [ABSTRACT FROM AUTHOR]