Association between COVID-19 and bacterial infection. A literature review

SARS-CoV-2 is the causative agent of COVID-19, which has impacted all aspects of society, especially during the pandemic period between 2020 – 2023. The clinical presentation of COVID-19 is variable, with asymptomatic cases or favorable resolutions. A complication in severe COVID-19 patients is the concurrent infection with other pathogens, particularly bacterial infections with multidrug-resistant strains. This work conducted a review to investigate the impact of the pandemic on healthcare systems in terms of the co-occurrence of SARS-CoV-2 infections and other bacterial pathogens, as well as the problem of antimicrobial resistance. The results of this review show that co-infections mainly occur in patients with comorbidities and a more severe course of COVID-19. This implies a greater need for special care and prolonged hospital stays, increasing the possibility of complications and healthcare-associated infections. Initial indiscriminate antibiotic treatment practices by clinical staff were also reported, along with a shift in focus towards pandemic care, neglecting antimicrobial resistance surveillance programs. In the antimicrobial resistance profiles, the presence of resistance mechanisms was evidenced, including an increase in the reporting of MRSA, Gram-negative bacilli with ESBL or NDM, with high resistance to carbapenems, polymyxin B, among others. Notable organisms include Acinetobacter. baumannii, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, species of the genera Enterococcus and Streptococcus, Staphylococcus aureus including MRSA, among others. Altogether, the need to continue monitoring, evaluating isolates, and establishing necessary protocols to provide appropriate management of co-occurrence of infections and antimicrobial resistance monitoring at local and regional levels is evident, especially in the face of large-scale epidemiological events such as the COVID-19 pandemic.