key: cord-0848131-8x80phns authors: Langford, Bradley J.; So, Miranda; Leung, Valerie; Raybardhan, Sumit; Lo, Jennifer; Kan, Tiffany; Leung, Felicia; Daneman, Nick; MacFadden, Derek R.; Soucy, Jean-Paul R. title: 'Predictors and microbiology of respiratory and bloodstream bacterial infection in patients with COVID-19' – Author’s reply date: 2022-02-04 journal: Clin Microbiol Infect DOI: 10.1016/j.cmi.2022.01.020 sha: 80fb8f28a80fa20cc70e7551525cd061458bc695 doc_id: 848131 cord_uid: 8x80phns nan We thank the authors for their interest and comments regarding our publication in CMI [1] . Given the vast amount of literature published on the topic of co-infections and secondary infections in COVID-19, and the heterogeneity in publication quality, methodological approach, and data reporting strategies, it was necessary to make some assumptions regarding whether studies met inclusion criteria. We agree there are certainly limitations that may impact the precision of our estimate and have highlighted some of such concerns in our discussion. Nevertheless, each of the 171 studies were reviewed by a minimum of two authors to determine if inclusion criteria were met. However, the inclusion of some studies may still be debatable. Although serological testing was an exclusion criterion, certain studies did not specify the microbiological method of testing [2] and did not explicitly indicate serological testing was used (e.g., studies may have used PCR or serology to detect Mycoplasma spp.), hence these studies were included. We also made a decision to include studies of patients with ventilator-associated pneumonia (without further microbiological detail) since the vast majority are caused by bacteria [3, 4] . Our meta-analysis and regression specifically focused on concomitant infection caused by bacteria, so all studies counted towards an estimate of bacterial co-infection or bacterial secondary infection. Table 1 final two columns should indicate bacterial co-infection and bacterial secondary infection. We hope this helps to clarify. Our exclusion of letters to the editor was meant to remove any commentary or narrative -type correspondence. However, we did include research letters that provided sufficient data to meet inclusion criteria [5, 6] . Given some of these limitations mentioned, we have updated our inclusion criteria in our living review so that our next update will be more stringent with respect to study inclusion (e.g., requiring an explicit statement of microbiological testing approach, exclusion of any type of J o u r n a l P r e -p r o o f letter/correspondence) [7] . The full search strategy for our most recent rapid review is now included in the supplementary material. The authors have no relevant conflicts of interest to declare. No external funding was received for this project. Writing Predictors and microbiology of respiratory and bloodstream bacterial infection in patients with COVID-19: living rapid review update and meta-regression Clinical Characteristics and Outcomes of Older Patients with Coronavirus Disease 2019 (COVID-19) in Wuhan, China: A Single-Centered, Retrospective Study Microbial cause of ICU-acquired pneumonia: hospitalacquired pneumonia versus ventilator-associated pneumonia Annual Update in Intensive Care and Emergency Medicine Secondary infection among hospitalized COVID -19 patients: A retrospective cohort study in a tertiary care setting Bacterial coinfection in critically ill COVID-19 patients with severe pneumonia Antibiotic Resistant infections in Patients with COVID-19: A Rapid Review