Loading…

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...

Full description

Saved in:
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:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c499t-6a46f00d49ed4aa844b88fabfef48522dde4100dad2f0865baea89cb72e44a5d3
cites cdi_FETCH-LOGICAL-c499t-6a46f00d49ed4aa844b88fabfef48522dde4100dad2f0865baea89cb72e44a5d3
container_end_page
container_issue 1
container_start_page 53
container_title Antibiotics (Basel)
container_volume 12
creator Rachina, Svetlana
Kiyakbaev, Gairat
Antonova, Elena
Mescheryakov, Alexey
Kupryushina, Olga
Hewathanthirige, Girindu
Palagin, Ivan
Kozhevnikova, Elena
Sukhorukova, Marina
Strelkova, Daria
description 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.
doi_str_mv 10.3390/antibiotics12010053
format article
fullrecord <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_4a6c033907a742cd99b260c2b6ba393f</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_4a6c033907a742cd99b260c2b6ba393f</doaj_id><sourcerecordid>2768243253</sourcerecordid><originalsourceid>FETCH-LOGICAL-c499t-6a46f00d49ed4aa844b88fabfef48522dde4100dad2f0865baea89cb72e44a5d3</originalsourceid><addsrcrecordid>eNptkl9v1iAUxhujccvcJzAxJN54U6VAKXih2eqfvcnijJneklOgG68tVGhn9gX83FLfuWxGbiCH5_mF83CK4mmFX1Iq8Svws-tcmJ1OFcEVxjV9UOwT3MiSU0Ee3jnvFYcpbXFesqICi8fFHuW8qUjN9otfR6gdnHcaBtRCsij06FNIQYfR5dJnb5cxeAcIEgLUhnEasnZ2wa_K9uzb5l1ZydfoJPxEc0DHMIDXFh1bb3s3Z4836ItL39Mq34zj4kNapinalNyVReeXNsJ0_fZJ8aiHIdnDm_2g-Prh_Xl7Up6efdy0R6elZlLOJQfGe4wNk9YwAMFYJ0QPXW97JmpCjLEsZ2HAkB4LXndgQUjdNcQyBrWhB8VmxzUBtmqKboR4rQI49acQ4oWCmEMdrGLANV6zbqBhRBspO8KxJh3vgEraZ9abHWtautEabf0cYbgHvX_j3aW6CFdKipox0WTAixtADD8Wm2Y1uqTtkCO0YUmKNFwQRklNs_T5P9JtWKLPUa2q_JecsBVIdyodQ0rR9rePqbBaW1H_GZvsena3j1vP3yGhvwHiKsHC</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2767126247</pqid></control><display><type>article</type><title>A Clinical Case of Nosocomial Pneumonia as a Complication of COVID-19: How to Balance Benefits and Risks of Immunosuppressive Therapy?</title><source>PubMed Central Free</source><source>ProQuest - Publicly Available Content Database</source><source>Coronavirus Research Database</source><creator>Rachina, Svetlana ; Kiyakbaev, Gairat ; Antonova, Elena ; Mescheryakov, Alexey ; Kupryushina, Olga ; Hewathanthirige, Girindu ; Palagin, Ivan ; Kozhevnikova, Elena ; Sukhorukova, Marina ; Strelkova, Daria</creator><creatorcontrib>Rachina, Svetlana ; Kiyakbaev, Gairat ; Antonova, Elena ; Mescheryakov, Alexey ; Kupryushina, Olga ; Hewathanthirige, Girindu ; Palagin, Ivan ; Kozhevnikova, Elena ; Sukhorukova, Marina ; Strelkova, Daria</creatorcontrib><description>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.</description><identifier>ISSN: 2079-6382</identifier><identifier>EISSN: 2079-6382</identifier><identifier>DOI: 10.3390/antibiotics12010053</identifier><identifier>PMID: 36671254</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>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</subject><ispartof>Antibiotics (Basel), 2022-12, Vol.12 (1), p.53</ispartof><rights>2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 by the authors. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c499t-6a46f00d49ed4aa844b88fabfef48522dde4100dad2f0865baea89cb72e44a5d3</citedby><cites>FETCH-LOGICAL-c499t-6a46f00d49ed4aa844b88fabfef48522dde4100dad2f0865baea89cb72e44a5d3</cites><orcidid>0000-0002-3329-7846 ; 0000-0002-8882-6143 ; 0000-0001-9613-9717 ; 0000-0002-1005-9212</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2767126247/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2767126247?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,38516,43895,44590,53791,53793,74412,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36671254$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rachina, Svetlana</creatorcontrib><creatorcontrib>Kiyakbaev, Gairat</creatorcontrib><creatorcontrib>Antonova, Elena</creatorcontrib><creatorcontrib>Mescheryakov, Alexey</creatorcontrib><creatorcontrib>Kupryushina, Olga</creatorcontrib><creatorcontrib>Hewathanthirige, Girindu</creatorcontrib><creatorcontrib>Palagin, Ivan</creatorcontrib><creatorcontrib>Kozhevnikova, Elena</creatorcontrib><creatorcontrib>Sukhorukova, Marina</creatorcontrib><creatorcontrib>Strelkova, Daria</creatorcontrib><title>A Clinical Case of Nosocomial Pneumonia as a Complication of COVID-19: How to Balance Benefits and Risks of Immunosuppressive Therapy?</title><title>Antibiotics (Basel)</title><addtitle>Antibiotics (Basel)</addtitle><description>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.</description><subject>Abscesses</subject><subject>Antibiotics</subject><subject>carbapenemase</subject><subject>Case Report</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Dexamethasone</subject><subject>Drug dosages</subject><subject>Drug resistance</subject><subject>Gram-negative bacteria</subject><subject>Health risks</subject><subject>Hospitals</subject><subject>Immunomodulation</subject><subject>Immunomodulators</subject><subject>Immunosuppressive agents</subject><subject>immunosuppressive therapy</subject><subject>Inflammation</subject><subject>Intensive care</subject><subject>Interleukin 6</subject><subject>Klebsiella</subject><subject>Laboratories</subject><subject>Lungs</subject><subject>Mortality</subject><subject>Nosocomial infection</subject><subject>Nosocomial infections</subject><subject>nosocomial pneumonia</subject><subject>Pandemics</subject><subject>Pathogens</subject><subject>Patients</subject><subject>Pneumonia</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><issn>2079-6382</issn><issn>2079-6382</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>COVID</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptkl9v1iAUxhujccvcJzAxJN54U6VAKXih2eqfvcnijJneklOgG68tVGhn9gX83FLfuWxGbiCH5_mF83CK4mmFX1Iq8Svws-tcmJ1OFcEVxjV9UOwT3MiSU0Ee3jnvFYcpbXFesqICi8fFHuW8qUjN9otfR6gdnHcaBtRCsij06FNIQYfR5dJnb5cxeAcIEgLUhnEasnZ2wa_K9uzb5l1ZydfoJPxEc0DHMIDXFh1bb3s3Z4836ItL39Mq34zj4kNapinalNyVReeXNsJ0_fZJ8aiHIdnDm_2g-Prh_Xl7Up6efdy0R6elZlLOJQfGe4wNk9YwAMFYJ0QPXW97JmpCjLEsZ2HAkB4LXndgQUjdNcQyBrWhB8VmxzUBtmqKboR4rQI49acQ4oWCmEMdrGLANV6zbqBhRBspO8KxJh3vgEraZ9abHWtautEabf0cYbgHvX_j3aW6CFdKipox0WTAixtADD8Wm2Y1uqTtkCO0YUmKNFwQRklNs_T5P9JtWKLPUa2q_JecsBVIdyodQ0rR9rePqbBaW1H_GZvsena3j1vP3yGhvwHiKsHC</recordid><startdate>20221229</startdate><enddate>20221229</enddate><creator>Rachina, Svetlana</creator><creator>Kiyakbaev, Gairat</creator><creator>Antonova, Elena</creator><creator>Mescheryakov, Alexey</creator><creator>Kupryushina, Olga</creator><creator>Hewathanthirige, Girindu</creator><creator>Palagin, Ivan</creator><creator>Kozhevnikova, Elena</creator><creator>Sukhorukova, Marina</creator><creator>Strelkova, Daria</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T7</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>COVID</scope><scope>DWQXO</scope><scope>FR3</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M7P</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-3329-7846</orcidid><orcidid>https://orcid.org/0000-0002-8882-6143</orcidid><orcidid>https://orcid.org/0000-0001-9613-9717</orcidid><orcidid>https://orcid.org/0000-0002-1005-9212</orcidid></search><sort><creationdate>20221229</creationdate><title>A Clinical Case of Nosocomial Pneumonia as a Complication of COVID-19: How to Balance Benefits and Risks of Immunosuppressive Therapy?</title><author>Rachina, Svetlana ; Kiyakbaev, Gairat ; Antonova, Elena ; Mescheryakov, Alexey ; Kupryushina, Olga ; Hewathanthirige, Girindu ; Palagin, Ivan ; Kozhevnikova, Elena ; Sukhorukova, Marina ; Strelkova, Daria</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c499t-6a46f00d49ed4aa844b88fabfef48522dde4100dad2f0865baea89cb72e44a5d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Abscesses</topic><topic>Antibiotics</topic><topic>carbapenemase</topic><topic>Case Report</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>Dexamethasone</topic><topic>Drug dosages</topic><topic>Drug resistance</topic><topic>Gram-negative bacteria</topic><topic>Health risks</topic><topic>Hospitals</topic><topic>Immunomodulation</topic><topic>Immunomodulators</topic><topic>Immunosuppressive agents</topic><topic>immunosuppressive therapy</topic><topic>Inflammation</topic><topic>Intensive care</topic><topic>Interleukin 6</topic><topic>Klebsiella</topic><topic>Laboratories</topic><topic>Lungs</topic><topic>Mortality</topic><topic>Nosocomial infection</topic><topic>Nosocomial infections</topic><topic>nosocomial pneumonia</topic><topic>Pandemics</topic><topic>Pathogens</topic><topic>Patients</topic><topic>Pneumonia</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rachina, Svetlana</creatorcontrib><creatorcontrib>Kiyakbaev, Gairat</creatorcontrib><creatorcontrib>Antonova, Elena</creatorcontrib><creatorcontrib>Mescheryakov, Alexey</creatorcontrib><creatorcontrib>Kupryushina, Olga</creatorcontrib><creatorcontrib>Hewathanthirige, Girindu</creatorcontrib><creatorcontrib>Palagin, Ivan</creatorcontrib><creatorcontrib>Kozhevnikova, Elena</creatorcontrib><creatorcontrib>Sukhorukova, Marina</creatorcontrib><creatorcontrib>Strelkova, Daria</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Coronavirus Research Database</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Biological Science Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest - Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals (Open Access)</collection><jtitle>Antibiotics (Basel)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rachina, Svetlana</au><au>Kiyakbaev, Gairat</au><au>Antonova, Elena</au><au>Mescheryakov, Alexey</au><au>Kupryushina, Olga</au><au>Hewathanthirige, Girindu</au><au>Palagin, Ivan</au><au>Kozhevnikova, Elena</au><au>Sukhorukova, Marina</au><au>Strelkova, Daria</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Clinical Case of Nosocomial Pneumonia as a Complication of COVID-19: How to Balance Benefits and Risks of Immunosuppressive Therapy?</atitle><jtitle>Antibiotics (Basel)</jtitle><addtitle>Antibiotics (Basel)</addtitle><date>2022-12-29</date><risdate>2022</risdate><volume>12</volume><issue>1</issue><spage>53</spage><pages>53-</pages><issn>2079-6382</issn><eissn>2079-6382</eissn><abstract>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.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>36671254</pmid><doi>10.3390/antibiotics12010053</doi><orcidid>https://orcid.org/0000-0002-3329-7846</orcidid><orcidid>https://orcid.org/0000-0002-8882-6143</orcidid><orcidid>https://orcid.org/0000-0001-9613-9717</orcidid><orcidid>https://orcid.org/0000-0002-1005-9212</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 2079-6382
ispartof Antibiotics (Basel), 2022-12, Vol.12 (1), p.53
issn 2079-6382
2079-6382
language eng
recordid cdi_doaj_primary_oai_doaj_org_article_4a6c033907a742cd99b260c2b6ba393f
source PubMed Central Free; ProQuest - Publicly Available Content Database; Coronavirus Research Database
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
title A Clinical Case of Nosocomial Pneumonia as a Complication of COVID-19: How to Balance Benefits and Risks of Immunosuppressive Therapy?
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-04T12%3A10%3A30IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20Clinical%20Case%20of%20Nosocomial%20Pneumonia%20as%20a%20Complication%20of%20COVID-19:%20How%20to%20Balance%20Benefits%20and%20Risks%20of%20Immunosuppressive%20Therapy?&rft.jtitle=Antibiotics%20(Basel)&rft.au=Rachina,%20Svetlana&rft.date=2022-12-29&rft.volume=12&rft.issue=1&rft.spage=53&rft.pages=53-&rft.issn=2079-6382&rft.eissn=2079-6382&rft_id=info:doi/10.3390/antibiotics12010053&rft_dat=%3Cproquest_doaj_%3E2768243253%3C/proquest_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c499t-6a46f00d49ed4aa844b88fabfef48522dde4100dad2f0865baea89cb72e44a5d3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2767126247&rft_id=info:pmid/36671254&rfr_iscdi=true