COINFECCIÓN POR KLEBSIELLA PNEUMONIAE EN PACIENTES PEDIÁTRICOS CON COVID-19: UNA REVISIÓN
DOI:
https://doi.org/10.56238/arev7n10-267Palabras clave:
Resistencia a los Antimicrobianos, COVID-19, Infecciones Asociadas a la Atención Médica (IAAS), Klebsiella Pneumoniae, SARS-Cov-2Resumen
La COVID-19 en pacientes pediátricos, aunque a menudo menos grave que en adultos, puede complicarse con coinfecciones bacterianas, en particular por Klebsiella pneumoniae (KP), un patógeno oportunista asociado con altas tasas de resistencia a los antimicrobianos y resultados clínicos adversos. Este artículo revisa sistemáticamente la literatura sobre la coinfección por KP en niños con COVID-19, destacando su prevalencia, factores de riesgo, impacto clínico y estrategias de manejo. Se realizó una revisión bibliográfica integradora que abarcó artículos publicados entre 2020 y 2025 en las bases de datos PubMed, Scopus, Web of Science y ScienceDirect. Se incluyeron estudios observacionales, retrospectivos y prospectivos, centrados en pacientes pediátricos diagnosticados con COVID-19 y coinfección por KP. El análisis temático identificó patrones de prevalencia y gravedad clínica. Este estudio refuerza que, si bien la COVID-19 en niños suele presentar una evolución leve a moderada, la coinfección por KP representa un factor agravante y destaca la falta de estudios pediátricos sólidos que aborden la coinfección por KP en pacientes pediátricos con COVID-19.
Descargas
Referencias
1. Verani JR, Blau DM, Gurley ES, et al (2024) Child deaths caused by Klebsiella pneumoniae in sub-Saharan Africa and south Asia: a secondary analysis of Child Health and Mortality Prevention Surveillance (CHAMPS) data. Lancet Microbe 5:e131–e141. https://doi.org/10.1016/S2666-5247(23)00290-2
2. Kernéis S, Lucet JC, Santoro A, Meschiari M (2021) Individual and collective impact of Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae in patients admitted to the ICU. J Antimicrob Chemother 76:i19–i26. https://doi.org/10.1093/jac/dkaa494
3. Vidal DC, Kuzma J, Hensley J, et al (2023) AGE-BASED VARIABILITY OF ABSOLUTE LYMPHOCYTE COUNT IN CHILDREN WITH SEPTIC SHOCK. Crit Care Med 51:355. https://doi.org/10.1097/01.ccm.0000908648.28830.ae
4. Koutsogiannaki S, Kim S, Yuki K (2023) Age-dependent transcriptomic profiles of leukocytes in pediatric population. Clin Immunol Orlando Fla 255:109728. https://doi.org/10.1016/j.clim.2023.109728
5. Dumitru IM, Dumitrascu M, Vlad ND, et al (2021) Carbapenem-Resistant Klebsiella pneumoniae Associated with COVID-19. Antibiotics 10:561. https://doi.org/10.3390/antibiotics10050561
6. Lee J, Chang E, Jung J, et al (2022) Bacterial Co-Infection and Empirical Antibacterial Therapy in Patients With COVID-19. J Korean Med Sci 38:. https://doi.org/10.3346/jkms.2023.38.e37
7. Ahmad T, Khan M, Haroon, et al (2020) COVID-19: Zoonotic aspects. Travel Med Infect Dis 36:101607. https://doi.org/10.1016/j.tmaid.2020.101607
8. Ahmad W, Hernandez JA, Saini S, Mishra RK (2021) The US equity sectors, implied volatilities, and COVID-19: What does the spillover analysis reveal? Resour Policy 72:
9. Jia W, Wang J, Sun B, et al (2021) The Mechanisms and Animal Models of SARS-CoV-2 Infection. Front Cell Dev Biol 9:. https://doi.org/10.3389/fcell.2021.578825
10. Biskupek I, Sieradzan A, Czaplewski C, et al (2022) Theoretical Investigation of the Coronavirus SARS-CoV-2 (COVID-19) Infection Mechanism and Selectivity. Molecules 27:2080. https://doi.org/10.3390/molecules27072080
11. Khreefa Z, Barbier MT, Koksal AR, et al (2023) Pathogenesis and Mechanisms of SARS-CoV-2 Infection in the Intestine, Liver, and Pancreas. Cells 12:262. https://doi.org/10.3390/cells12020262
12. Morovati H, Eslami S, Bonab HF, et al (2022) Bacterial and fungal coinfections among patients with COVID-19 in Zanjan, Northwest of Iran; a single-center observational with meta-analysis of the literature. Iran J Microbiol 14:624–635. https://doi.org/10.18502/ijm.v14i5.10955
13. Murray CJ, Ikuta KS, Sharara F, et al (2022) Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. The Lancet 399:629–655. https://doi.org/10.1016/S0140-6736(21)02724-0
14. Binkhamis KM, Alhaider AS, Sayed AK, et al (2023) Prevalence of secondary infections and association with mortality rates of hospitalized COVID-19 patients. Ann Saudi Med 43:243–253. https://doi.org/10.5144/0256-4947.2023.243
15. Bender RG, Sirota SB, Swetschinski LR, et al (2024) Global, regional, and national incidence and mortality burden of non-COVID-19 lower respiratory infections and aetiologies, 1990–2021: a systematic analysis from the Global Burden of Disease Study 2021. Lancet Infect Dis 24:974–1002. https://doi.org/10.1016/S1473-3099(24)00176-2
16. Arcari G, Raponi G, Sacco F, et al (2021) Klebsiella pneumoniae infections in COVID-19 patients: a 2-month retrospective analysis in an Italian hospital. Int J Antimicrob Agents 57:106245. https://doi.org/10.1016/j.ijantimicag.2020.106245
17. Zhu X, Ge Y, Wu T, et al (2020) Co-infection with respiratory pathogens among COVID-2019 cases. Virus Res 285:198005. https://doi.org/10.1016/j.virusres.2020.198005
18. Braun V, and Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3:77–101. https://doi.org/10.1191/1478088706qp063oa
19. Barsanti G, Driutti M, Brunelli L, Cocconi R (2021) KPC rise in an Italian academic hospital during COVID‑19 pandemic. Italian, p 140
20. Sreenath K, Batra P, Vinayaraj EV, et al (2021) Coinfections with Other Respiratory Pathogens among Patients with COVID-19. Microbiol Spectr 9:10.1128/spectrum.00163-21. https://doi.org/10.1128/spectrum.00163-21
21. Ficik J, Andrezál M, Drahovská H, et al (2023) Carbapenem-Resistant Klebsiella pneumoniae in COVID-19 Era—Challenges and Solutions. Antibiotics 12:1285. https://doi.org/10.3390/antibiotics12081285
22. Li Q, Song M, Hu Z, et al (2024) Pediatric respiratory pathogen dynamics in Southern Sichuan, China: a retrospective analysis of gender, age, and seasonal trends. Front Pediatr 12:. https://doi.org/10.3389/fped.2024.1374571
23. Raychaudhuri D, Sarkar M, Roy A, et al (2021) COVID-19 and Co-infection in children: The Indian perspectives. J Trop Pediatr 67:. https://doi.org/10.1093/tropej/fmab073
24. Yakovlev AS, Afanasev VV, Alekseenko SI, et al (2024) Prevalence and Clinical Impact of Viral and Bacterial Coinfections in Hospitalized Children and Adolescents Aged under 18 Years with COVID-19 during the Omicron Wave in Russia. Viruses 16:1180. https://doi.org/10.3390/v16081180
25. Xu X, Meng L, Li J, et al (2025) Analysis of the potentially pathogenic bacteria of lower respiratory tract infections in children per-, during and post-COVID-19: a retrospective study. Eur J Clin Microbiol Infect Dis 44:167–180. https://doi.org/10.1007/s10096-024-04991-9
26. Yue Y, Wu D, Zeng Q, et al (2025) Changes in children respiratory infections pre and post COVID-19 pandemic. Front Cell Infect Microbiol 15:1549497. https://doi.org/10.3389/fcimb.2025.1549497
27. Singh V, Upadhyay P, Reddy J, Granger J (2021) SARS-CoV-2 respiratory co-infections: Incidence of viral and bacterial co-pathogens. Int J Infect Dis 105:617–620. https://doi.org/10.1016/j.ijid.2021.02.087
28. Ciptaningtyas VR, Hapsari R, Lestari ES, et al (2022) Bacterial colonization of the upper airways of children positive and negative for SARS-CoV-2 during the COVID-19 pandemic. BMC Infect Dis 22:860. https://doi.org/10.1186/s12879-022-07851-z
29. Ciptaningtyas VR, Mast Q de, Jonge MI de (2021) The burden and etiology of lower respiratory tract infections in children under five years of age in Indonesia. J Infect Dev Ctries 15:603–614. https://doi.org/10.3855/jidc.14268
30. Kenmoe S, Tcharnenwa C, Monamele GC, et al (2019) Comparison of FTD® respiratory pathogens 33 and a singleplex CDC assay for the detection of respiratory viruses: A study from Cameroon. Diagn Microbiol Infect Dis 94:236–242. https://doi.org/10.1016/j.diagmicrobio.2019.01.007
31. Sapra M, Kirubanandhan S, Kanta P, et al (2022) Respiratory viral infections other than SARS CoV-2 among the North Indian patients presenting with acute respiratory illness during the first COVID-19 wave. VirusDisease 33:57–64. https://doi.org/10.1007/s13337-022-00761-3
