Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 6 4 2022 07 21 e46 e46 Somayeh Mehrpour Department of Anesthesiology and Critical Car, Qom University of Medical Sciences, Qom, Iran Narges Kalhor Student Research Committee, Qom University of Medical Sciences, Qom, Iran Sarah Afshari Student Research Committee, Qom University of Medical Sciences, Qom, Iran Reihane Tabaraii Clinical Research Development Center, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran 2022 07 06 2022 07 07 To the Editor-in-Chief In viral pandemics, the possibility of accompanied bacterial infections is always a serious challenge for health care providers. In the recent pandemic with COVID-19, studies showed an increase in bacterial infections in patients with COVID-19, especially those requiring intensive care unit (ICU) admission. Various meta-analyses have shown that the prevalence of some secondary bacterial infections, especially infection with Mycoplasma pneumoniae, Gram-negative germs like extended-spectrum beta-lactamase, and Klebsiella pneumoniae, has increased significantly. Recent studies have also shown that the pathogens that cause bloodstream infections have changed during the COVID-19 pandemic for a variety of reasons, including the widespread use of antibiotics, the effects of COVID-19 on the immune system, and so on. Increased prevalence of bloodstream infections with Gram-negative bacteria that are resistant to third generation of cephalosporins and carbapenems in patients with COVID-19 has been reported in several studies. Studies have also shown increased isolation of pathogens such as members of the Enterobacteriaceae family, including Klebsiella and Escherichia specimens, from blood cultures of patients hospitalized due to COVID-19. https://fem.tums.ac.ir/index.php/fem/article/view/1038 https://fem.tums.ac.ir/index.php/fem/article/download/1038/416