African Journal of
Microbiology Research

  • Abbreviation: Afr. J. Microbiol. Res.
  • Language: English
  • ISSN: 1996-0808
  • DOI: 10.5897/AJMR
  • Start Year: 2007
  • Published Articles: 5233

Full Length Research Paper

ICU COVID-19 patients with bacterial and fungal super-infections in Saudi Arabia

Manal M Darwish
  • Manal M Darwish
  • Microbiology and Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
  • Google Scholar
Mohammed Ahmed Garout
  • Mohammed Ahmed Garout
  • Community Medicine and Public Health, Faculty of Medicine Umm AL-Qura University, Makkah, KSA.
  • Google Scholar
Altaf A. Abdul Khaliq
  • Altaf A. Abdul Khaliq
  • Clinical biochemistry, Faculty of Medicine, Umm AL-Qura University, Makkah, KSA.
  • Google Scholar
Magda R. Abdultawab
  • Magda R. Abdultawab
  • Microbiology and Immunology and Infection Control, Faculty of Medicine, Ain Shams University, Cairo, Egypt, KSA, Saudi Arabia.
  • Google Scholar

  •  Received: 29 November 2022
  •  Accepted: 17 February 2023
  •  Published: 31 March 2023


Bacterial and fungal infections in COVID-19 patients were reported all over the world. A retrospective study was conducted to determine the prevalence of bacterial and fungal superinfections in COVID-19 positive patients between April 2020 and December 2021. This research included patients admitted in a specialized medical center in Saudi Arabia. A total of 2643 patients with confirmed diagnosis of COVID-19 via reverse transcriptase-polymerase chain reaction assay (RT-PCR) conducted on nasopharyngeal swab and chest computed tomography. The age forty-nine years (SD 12·5) 2087 were men (79%). Patients with positive cultures for bacteria or fungi were included in the study, and patients with negative cultures were excluded. Total number of COVID-19 patients who acquired bacterial infection was 509 (19%) and two hundred forty-six (246) of COVID-19 patients were admitted to ICU and were under mechanical ventilation (9.3%). All mechanically ventilated cases developed bacterial ventilator associated pneumonia. Multidrug resistant organisms represent 97%. Extended spectrum b-lactamase comprise 35.1%, Methicillin resistant Staph aureus 32.2%, vancomycin resistant Enterococci 2.1%. Clostridium difficile was 1.7%. 46 patients under mechanical ventilation acquired fungal superinfection (18.6%) with long duration of mechanical ventilation more than 14 days (p value=0.019) and under dexamethasone treatment (p value=0.027). Candida is the most common type of fungi isolated (89%). Candida auris isolated from three cases (6.5%), one case developed invasive mucormycosis (2%) one acquired invasive Aspergillosis (2%). 5 patients died (11%). This research tries to provide factual evidence of types of bacterial and fungal superinfection in COVID-19 cases and implement prevention and control measures of infection.


Key words: Bacteria, fungal, COVID-19, infections, PCR.