• Emergence of Gram-Negative Bacterial Infections during COVID-19 Pandemic in Sari Cardiology Hospital
  • Maryam Andishgar,1,* Masoume Bagheri Astani,2 Mahnaz Nasrollahi,3 Farnoosh Fadaei,4 Roshanak Haghiri Santeh,5 Maedeh Kazemi,6
    1. Department of Medical Laboratory Science, Faculty of Medicine, Sari branch, Islamic Azad University, Sari, Iran
    2. Department of Medical Laboratory Science, Faculty of Medicine, Sari branch, Islamic Azad University, Sari, Iran
    3. Department of Medical Laboratory Science, Faculty of Medicine, Sari branch, Islamic Azad University, Sari, Iran
    4. Department of Medical Laboratory Science, Faculty of Medicine, Sari branch, Islamic Azad University, Sari, Iran
    5. Department of Medical Laboratory Science, Faculty of Medicine, Sari branch, Islamic Azad University, Sari, Iran
    6. Department of Medical Laboratory Science, Faculty of Medicine, Sari branch, Islamic Azad University, Sari, Iran


  • Introduction: The COVID-19 pandemic caused by the coronavirus SARS-CoV-2 has resulted in a global health crisis with respiratory complications being the primary cause of mortality. Evidence suggests an increase in secondary bacterial infections or hospital-acquired infections, particularly caused by mostly gram-negative bacteria. These bacteria pose a great threat to patients due to their resistance to most antibiotics which makes them difficult to treat. Prolonged hospital stays and the use of medical devices increase the risk of acquiring these infections. This paper provides an in-depth review and statistics of gram-negative bacterial infections during COVID-19 pandemic in Sari Cardiology Hospital.
  • Methods: This study analyzed data from patients admitted to the hospital between July 2020 and February 2022. We collected demographic information, medical histories and laboratory results. 351 gram-negative samples were isolated from patients. Microbiological cultures were performed on respiratory samples, blood cultures, stool and urine samples and other relevant specimens from patients with signs of infection. Gram-negative bacteria were identified using standard laboratory techniques such as antibiotic susceptibility test, TSI, IMViC and other methods. Disk diffusion testing was performed according to CLSI standards.
  • Results: A total of 351 patients were diagnosed with gram-negative bacterial infections. The most frequently isolated gram-negative bacteria was Escherichia Coli, accounting for 60.3% of all cases. Some other gram negative bacteria collected were Klebsiella, Pseudomonas, Citrobacter, Acinetobacter, Enterobacteriacae and CoNS. Antimicrobial susceptibility testing revealed varying resistance patterns among the isolated gram-negative bacteria e.g. 54% of the identified E.Coli strains showed resistance to commonly used antibiotics, such as ciprofloxacin. Or 68% of Enterobacteriacae strains showed resistance to carbapenem.
  • Conclusion: This study highlights the emergence of gram-negative bacterial infections during the COVID-19 pandemic in a local hospital. Health professionals can reduce the impact of these infections by recognizing the risk factors, understanding the basic mechanisms, and adopting appropriate strategies and diagnostic approaches. Continued research and collaboration are essential for addressing this emerging concern and informing future strategies.
  • Keywords: COVID-19 Pandemic, Gram Negative Bacterial Infections, Bacterial Sensitivity Tests