Coinfections and superinfections in critically ill COVID-19 patients in Ecuador: a cross-sectional study of bacterial and viral pathogens.

Introduction: The COVID-19 pandemic has deeply affected Latin America and Ecuador. Coinfections and superinfections increase the risk of morbidity and mortality in COVID-19 patients. This study examined co-infections and superinfections in critically ill COVID-19 patients admitted to the ICU of a tertiary hospital in Ecuador. Methods: A cross-sectional study was conducted from February to August 2021, including patients with a confirmed SARS-CoV-2 infection. Demographic data, clinical characteristics, and microbiological findings were analyzed to evaluate the presence of coinfections and superinfections. Results: A total of 24 patients were included, of whom 70.83% (17/24) experienced either coinfection or superinfection. Community-acquired coinfections were identified in 12.5% (3/24) of patients, whereas hospital-acquired superinfections were detected in 58.3% (14/24). The most frequently isolated pathogens were Discussion: These findings underscore the importance of robust monitoring of co-infections and superinfections in critically ill COVID-19 patients, especially in resource-limited settings. The high prevalence of these infections highlights the need for continued investment in microbiological surveillance, rapid diagnostics, and antimicrobial stewardship programs to mitigate long-term consequences and address the increasing threat of antimicrobial resistance.