Association between tocilizumab and emerging multidrug-resistant organisms in critically ill patients with COVID-19: A multicenter, retrospective cohort study

Abstract Background Tocilizumab is an IgG1 class recombinant humanized monoclonal antibody that directly inhibits the IL-6 receptor. Several randomized clinical trials have evaluated its safety and efficacy in patients with coronavirus disease 2019 (COVID-19), and these studies demonstrate conflicti...

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Autores principales:	Ohoud Aljuhani, Khalid Al Sulaiman, Adel Alshabasy, Khalid Eljaaly, Abdulrahman I. Al Shaya, Haytham Noureldeen, Mohammed Aboudeif, Bodoor Al Dosari, Amina Alkhalaf, Ghazwa B. Korayem, Muneera M. Aleissa, Hisham A. Badreldin, Shmeylan Al Harbi, Abdullah Alhammad, Ramesh Vishwakarma
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	COVID-19 SARS-Cov-2 Tocilizumab Secondary infection CRE Critically ill Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/c8d00252251f49ceb5ec2537a6f9c97e
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spelling	oai:doaj.org-article:c8d00252251f49ceb5ec2537a6f9c97e2021-11-08T11:18:45ZAssociation between tocilizumab and emerging multidrug-resistant organisms in critically ill patients with COVID-19: A multicenter, retrospective cohort study10.1186/s12879-021-06813-11471-2334https://doaj.org/article/c8d00252251f49ceb5ec2537a6f9c97e2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12879-021-06813-1https://doaj.org/toc/1471-2334Abstract Background Tocilizumab is an IgG1 class recombinant humanized monoclonal antibody that directly inhibits the IL-6 receptor. Several randomized clinical trials have evaluated its safety and efficacy in patients with coronavirus disease 2019 (COVID-19), and these studies demonstrate conflicting results. Our study aimed to determine the association between tocilizumab treatment and microbial isolation and emergence of multidrug-resistant bacteria in critically ill patients with COVID-19. Methods A multicenter retrospective cohort study was conducted at two tertiary government hospitals in Saudi Arabia. All critically ill patients admitted to intensive care units with a positive COVID-19 PCR test between March 1 and December 31, 2020, who met study criteria were included. Patients who received tocilizumab were compared to those who did not receive it. Results A total of 738 patients who met our inclusion criteria were included in the analysis. Of these, 262 (35.5%) received tocilizumab, and 476 (64.5%) were included in the control group. Patients who received tocilizumab had higher odds for microbial isolation (OR 1.34; 95% CI 0.91–1.94, p = 0.13); however, the difference was not statistically significant. Development of resistant organisms (OR 1.00; 95% CI 0.51–1.98, p = 0.99) or detection of carbapenem-resistant Enterobacteriaceae (CRE) (OR 0.67; 95% CI 0.29–1.54, p = 0.34) was not statistically significant between the two groups. Conclusions Tocilizumab use in critically ill patients with COVID-19 is not associated with higher microbial isolation, the emergence of resistant organisms, or the detection of CRE organisms.Ohoud AljuhaniKhalid Al SulaimanAdel AlshabasyKhalid EljaalyAbdulrahman I. Al ShayaHaytham NoureldeenMohammed AboudeifBodoor Al DosariAmina AlkhalafGhazwa B. KorayemMuneera M. AleissaHisham A. BadreldinShmeylan Al HarbiAbdullah AlhammadRamesh VishwakarmaBMCarticleCOVID-19SARS-Cov-2TocilizumabSecondary infectionCRECritically illInfectious and parasitic diseasesRC109-216ENBMC Infectious Diseases, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 SARS-Cov-2 Tocilizumab Secondary infection CRE Critically ill Infectious and parasitic diseases RC109-216
spellingShingle	COVID-19 SARS-Cov-2 Tocilizumab Secondary infection CRE Critically ill Infectious and parasitic diseases RC109-216 Ohoud Aljuhani Khalid Al Sulaiman Adel Alshabasy Khalid Eljaaly Abdulrahman I. Al Shaya Haytham Noureldeen Mohammed Aboudeif Bodoor Al Dosari Amina Alkhalaf Ghazwa B. Korayem Muneera M. Aleissa Hisham A. Badreldin Shmeylan Al Harbi Abdullah Alhammad Ramesh Vishwakarma Association between tocilizumab and emerging multidrug-resistant organisms in critically ill patients with COVID-19: A multicenter, retrospective cohort study
description	Abstract Background Tocilizumab is an IgG1 class recombinant humanized monoclonal antibody that directly inhibits the IL-6 receptor. Several randomized clinical trials have evaluated its safety and efficacy in patients with coronavirus disease 2019 (COVID-19), and these studies demonstrate conflicting results. Our study aimed to determine the association between tocilizumab treatment and microbial isolation and emergence of multidrug-resistant bacteria in critically ill patients with COVID-19. Methods A multicenter retrospective cohort study was conducted at two tertiary government hospitals in Saudi Arabia. All critically ill patients admitted to intensive care units with a positive COVID-19 PCR test between March 1 and December 31, 2020, who met study criteria were included. Patients who received tocilizumab were compared to those who did not receive it. Results A total of 738 patients who met our inclusion criteria were included in the analysis. Of these, 262 (35.5%) received tocilizumab, and 476 (64.5%) were included in the control group. Patients who received tocilizumab had higher odds for microbial isolation (OR 1.34; 95% CI 0.91–1.94, p = 0.13); however, the difference was not statistically significant. Development of resistant organisms (OR 1.00; 95% CI 0.51–1.98, p = 0.99) or detection of carbapenem-resistant Enterobacteriaceae (CRE) (OR 0.67; 95% CI 0.29–1.54, p = 0.34) was not statistically significant between the two groups. Conclusions Tocilizumab use in critically ill patients with COVID-19 is not associated with higher microbial isolation, the emergence of resistant organisms, or the detection of CRE organisms.
format	article
author	Ohoud Aljuhani Khalid Al Sulaiman Adel Alshabasy Khalid Eljaaly Abdulrahman I. Al Shaya Haytham Noureldeen Mohammed Aboudeif Bodoor Al Dosari Amina Alkhalaf Ghazwa B. Korayem Muneera M. Aleissa Hisham A. Badreldin Shmeylan Al Harbi Abdullah Alhammad Ramesh Vishwakarma
author_facet	Ohoud Aljuhani Khalid Al Sulaiman Adel Alshabasy Khalid Eljaaly Abdulrahman I. Al Shaya Haytham Noureldeen Mohammed Aboudeif Bodoor Al Dosari Amina Alkhalaf Ghazwa B. Korayem Muneera M. Aleissa Hisham A. Badreldin Shmeylan Al Harbi Abdullah Alhammad Ramesh Vishwakarma
author_sort	Ohoud Aljuhani
title	Association between tocilizumab and emerging multidrug-resistant organisms in critically ill patients with COVID-19: A multicenter, retrospective cohort study
title_short	Association between tocilizumab and emerging multidrug-resistant organisms in critically ill patients with COVID-19: A multicenter, retrospective cohort study
title_full	Association between tocilizumab and emerging multidrug-resistant organisms in critically ill patients with COVID-19: A multicenter, retrospective cohort study
title_fullStr	Association between tocilizumab and emerging multidrug-resistant organisms in critically ill patients with COVID-19: A multicenter, retrospective cohort study
title_full_unstemmed	Association between tocilizumab and emerging multidrug-resistant organisms in critically ill patients with COVID-19: A multicenter, retrospective cohort study
title_sort	association between tocilizumab and emerging multidrug-resistant organisms in critically ill patients with covid-19: a multicenter, retrospective cohort study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/c8d00252251f49ceb5ec2537a6f9c97e
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Association between tocilizumab and emerging multidrug-resistant organisms in critically ill patients with COVID-19: A multicenter, retrospective cohort study

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