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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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Published in: | Antibiotics (Basel) 2022-12, Vol.12 (1), p.53 |
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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 |
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, 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 ; 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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> |
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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? |
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