A Clinical Case of Nosocomial Pneumonia as a Complication of COVID-19: How to Balance Benefits and Risks of Immunosuppressive Therapy?

We report a Russian case of a 61-year-old male patient with confirmed COVID-19 infection who developed nosocomial pneumonia complicated by lung abscess associated with multi-drug-resistant isolates of and , which could have been provoked due to the immunosuppressive therapy. We discuss the existing...

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Bibliographic Details
Published in:Antibiotics (Basel) 2022-12, Vol.12 (1), p.53
Main Authors: Rachina, Svetlana, Kiyakbaev, Gairat, Antonova, Elena, Mescheryakov, Alexey, Kupryushina, Olga, Hewathanthirige, Girindu, Palagin, Ivan, Kozhevnikova, Elena, Sukhorukova, Marina, Strelkova, Daria
Format: Article
Language:English
Subjects:
Abscesses
Antibiotics
carbapenemase
Case Report
Coronaviruses
COVID-19
Dexamethasone
Drug dosages
Drug resistance
Gram-negative bacteria
Health risks
Hospitals
Immunomodulation
Immunomodulators
Immunosuppressive agents
immunosuppressive therapy
Inflammation
Intensive care
Interleukin 6
Klebsiella
Laboratories
Lungs
Mortality
Nosocomial infection
Nosocomial infections
nosocomial pneumonia
Pandemics
Pathogens
Patients
Pneumonia
Severe acute respiratory syndrome coronavirus 2
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Summary:We report a Russian case of a 61-year-old male patient with confirmed COVID-19 infection who developed nosocomial pneumonia complicated by lung abscess associated with multi-drug-resistant isolates of and , which could have been provoked due to the immunosuppressive therapy. We discuss the existing literature highlighting the issue of the prudent balance between benefits and risks when prescribing immunomodulators to hospitalized patients with COVID-19 due to the risk of difficult-to-treat nosocomial infections caused by MDR Gram-negative bacterial pathogens. Currently, there is evidence of a substantial positive effect of dexamethasone on the course of COVID-19 in patients requiring supplemental oxygen or anti-interleukin-6 drugs in individuals with prominent systemic inflammation. However, it seems that in real clinical practice, the proposed criteria for initiating treatment with immunomodulators are interpreted arbitrarily, and the doses of dexamethasone can significantly exceed those recommended.
ISSN:2079-6382
2079-6382
DOI:10.3390/antibiotics12010053