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J Korean Soc Emerg Med > Volume 36(6); 2025 > Article
Journal of The Korean Society of Emergency Medicine 2025;36(6): 232-240.
COVID-19 폐렴 환자의 객담배양 검사에서 확인된 세균 동시감염 원인균의 유행 시기에 따른 분포
김명훈 , 최동선 , 김지현
서울의료원 응급의학과
The distribution of bacterial coinfection identified in sputum culture tests of coronavirus disease 2019 pneumonia patients according to the epidemic period
Myeong Hoon Kim , Dong Sun Choi , Jee Hyeon Kim
Department of Emergency Medicine, Seoul Medical Center, Seoul, Korea
Correspondence  Dong Sun Choi ,Tel: 02-2276-8348, Fax: 02-2276-7418, Email: emergencychoi@gmail.com,
Received: July 19, 2024; Revised: October 29, 2024   Accepted: November 11, 2024.  Published online: December 31, 2025.
ABSTRACT
Objective:
This study compared the bacterial coinfection rates, identified major pathogens, and analyzed the antibiotic resistance patterns in pneumonia among coronavirus disease 2019 (COVID-19) patients across different pandemic periods (Before Delta, Delta, and Omicron) to inform empirical antibiotic usage.
Methods:
A retrospective observational study was conducted on COVID-19 pneumonia patients admitted to a secondary general hospital in Seoul from January 2020 to September 2023. The key variables analyzed included the mortality rates according to the admission period, the results from sputum and blood cultures, the incidence of bacterial coinfections, and comorbidities. Statistical analyses, including chi-square tests, analysis of variance, and logistic regression, were used to evaluate the effects of bacterial coinfections on mortality rates specific to each period.
Results:
Of 5,717 patients, bacterial coinfections were confirmed in 9.1%, with the highest rates observed during the Omicron period. Klebsiella pneumoniae was the most common pathogen identified, and positive sputum and blood cultures were linked to increased mortality. The mortality rates during the Omicron period were significantly higher than those during the Delta period.
Conclusion:
The incidence of bacterial coinfections and the prevalence of pathogens varied across pandemic periods. Therefore, antibiotics effective against hospital-acquired pneumonia pathogens should be considered if bacterial coinfections are suspected.
Key words: COVID-19; Pneumonia; Coinfection; Anti-bacterial agents; Mortality
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