Patient: Final Diagnosis: Symptoms: Male, 72-year-old COVID 19 infection • sepsis Cough • chest pain • urinary incontinence • respiratory distress • sore throat • fever • diarrhoea • loss of taste • anosmia Clinical Procedure: — Specialty: Infectious Diseases • Microbiology and Virology Objective: Background: Case Report: Conclusions: Rare coexistence of disease or pathology Bacterial Infections, especially, of the respiratory system, have been reported as one of the medical concerns in patients with the Coronavirus Disease-2019 (COVID-19), particularly those with multiple co-morbidities. We present a case of a diabetic patient with co-infection of multi-drug-resistant Kocuria rosea and methicillin-re-sistant Staphylococcus aureus (MRSA) who contracted COVID-19. A 72-year-old man with diabetes presented with symptoms including cough, chest pain, urinary incontinence, respiratory distress, sore throat, fever, diarrhea, loss of taste, and anosmia and was confirmed to have COVID-19. At admission, he was also found to have sepsis. MRSA was isolated in conjunction with another organism, re-sembling coagulase-negative Staphylococcus, which was misidentified using commercial biochemical testing systems. The strain was finally confirmed to be Kocuria rosea by 16S rRNA gene sequencing. Both strains were highly resistant to multiple classes of antibiotics, but the Kocuria rosea was resistant to all the cephalosporins, fluoroquinolones, and macrolides tested. The use of ceftriaxone and ciprofloxacin did not improve his condi-tion, which ultimately led to his death. This case report shows that the presence of multi-drug-resistant bacteria infections can be fatal in patients with COVID-19, especially in patients with other co-morbidities like diabetes. This case report also shows that biochemical testing may be inadequate in identifying emerging bacterial infections and there is a need to in-clude proper bacterial screening and treatment in the management of COVID-19, especially in patients with other co-morbidities and with indwelling devices.
