Viral Infections and Cancer Research

Microbiological Profiling of Secondary Infections in Dengue Patients: Implications for Clinical Management

Mohamed NurMohamed

Mohamed Nur Mohamed, Department of Public Health, World University of Bangladesh (WUB), Bangladesh, mohamednuur9920@gmail.com

Abdinasir AliMohamud

Abdinasir Ali Mohamud, Department of Internal Medicine, University of Somalia, Mogadishu, Somalia, abdinasirali01@gmail.com

Md. AshiqurRahman

Md. Ashiqur Rahman, Department of Laboratory Medicine, Novus Clinical Research Services Limited, Bangladesh, ararashiqur@gmail.com, Orcid id: 0000-0002-9430-5547

Sadia Islam

Sadia Islam, Department of Laboratory Medicine, Bangladesh Specialized Hospital PLC, Bangladesh, sadia.buhs.6700@gmail.com, Orcid id: 0009-0007-7932-3804

Keywords: Dengue; Secondary Infections; Bacterial Co-Infections; Fungal Infections; Antimicrobial Resistance

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Abstract

Background: Dengue fever is a prevalent vector-borne disease that can lead to severe complications, including dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Secondary infections in dengue patients, whether bacterial, fungal, or viral, are a significant concern as they can complicate the clinical course, worsen disease outcomes, and increase hospital stay duration. This study aims to identify the prevalence, microbial profile, and clinical impact of secondary infections in dengue patients, providing insights for better clinical management. Methods: This cross-sectional observational study was conducted on 110 dengue patients admitted during the peak transmission season. Patients were diagnosed with dengue based on serological tests (IgM/IgG) and/or RT-PCR. Clinical assessments, microbiological investigations (blood, urine, sputum, and wound cultures), and antimicrobial susceptibility tests were performed to identify secondary infections. Demographic, clinical, and laboratory data were recorded, and the correlation between secondary infections and disease severity was analyzed using statistical methods. Results: Among 110 dengue patients, 61.8% were male, and the highest age group was 21–40 years (28.2%). Most patients (70%) had no comorbidities. Fever (100%), rash (80%), and hemorrhagic manifestations (30%) were common, with severe forms (DSS/DHF) in 30%. Secondary infections occurred in 40.9% of patients, with bacterial infections (62.2%) being the most frequent. Secondary infections were more common in adults aged 21–60 years (45.5%) and those with severe dengue (62.5% vs. 35.4%, p40 years, comorbidities, and severe dengue (p=0.02, p=0.03, p=0.04, respectively). Patients with secondary infections had longer hospital stays (7.8 vs. 4.6 days, p

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