Novelty in Biomedicine

Vol. 14 No. 2 (2026)

Prevalence and Antimicrobial Resistance of Bacteria Isolated from Clinical Specimens of COVID-19 Patients Admitted to Fatemeh Zahra Hospital in Sari, Iran

Novelty in Biomedicine, Vol. 14 No. 2 (2026), 6 June 2026 , Page 84-90
https://doi.org/10.22037/nbm.v14i2.51098

Abstract

Background: The COVID-19 pandemic has heightened concerns over secondary bacterial infections, which worsen outcomes in hospitalized patients. This study investigated the prevalence and antibiotic resistance of bacteria isolated from clinical specimens of COVID-19 patients admitted to Fatemeh Zahra Hospital in Sari, Iran.

Materials and Methods: From September 2020 to August 2022, 3314 COVID-19 patients were included, with 55 positive cultures (including bacterial and fungal) obtained from 47 patients. The most common sources were urine (52.7%) and respiratory samples (38.1%). Gram-negative bacteria (58.9%), primarily Enterobacteriaceae (84.8%), were predominant, followed by Pseudomonas spp. and Acinetobacter. Gram-positive isolates included Staphylococcus aureus and coagulase-negative staphylococci. ICU-admitted patients showed higher co-infection rates, with increased mortality linked to bacterial infections. Antimicrobial susceptibility testing revealed concerning resistance patterns, including high resistance to ceftazidime (85% in Gram-negatives), imipenem (45% in Acinetobacter), and amikacin (50% in Pseudomonas), underscoring the challenge posed by multidrug-resistant organisms (MDROs). Among Gram-negative isolates, 30% were extensively drug-resistant (XDR).

Results: Despite a low overall co-infection rate (1.3%), bacterial infections significantly impacted disease severity and mortality. The findings align with regional studies highlighting Gram-negative pathogens as major contributors. Compared with pre-pandemic reports from Iran, resistance rates to carbapenems increased from ~43% to 65% among Acinetobacter baumannii. The rise in antimicrobial resistance (AMR) underscores the need for strict antibiotic stewardship and robust infection control measures.

Conclusion: This study emphasizes the critical role of bacterial co-infections in COVID-19 outcomes and calls for continuous surveillance to guide effective treatment strategies during the pandemic.

Keywords:
  • COVID-19
  • Coinfection
  • Antimicrobial resistance
  • Gram-negative pathogens
  • Hospital-acquired infections
  • Fungal infections

How to Cite

Azizi , S., Forouzanfar, A., Taheri, M., Abdi Seyedmahalleh, F., Dadfar, A., Basirpour, B., … Karimi-Yazdi, M. (2026). Prevalence and Antimicrobial Resistance of Bacteria Isolated from Clinical Specimens of COVID-19 Patients Admitted to Fatemeh Zahra Hospital in Sari, Iran. Novelty in Biomedicine, 14(2), 84–90. https://doi.org/10.22037/nbm.v14i2.51098

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