Bacterial Superinfection Is Found in a Minority of Patients Admitted with COVID-19 Respiratory Failure

When patients with COVID-19 are admitted to the intensive care unit, guidelines recommend empirical coverage for bacterial superinfection with community-associated pathogens. Broad-spectrum antibiotics also are given commonly when concern is raised for ventilator-associated pneumonia (VAP), often without sampling of lower airspaces to minimize risk to clinicians.

Based on local practice, investigators at a single Chicago hospital performed bronchoalveolar lavage (BAL) on all 179 patients admitted with respiratory failure due to COVID-19 during a 4-month period; three quarters of patients had initial BAL within 48 hours of admission. Additional BAL was performed in COVID-19 patients when clinical concern for VAP was present. Fluid was sent fo…