The prevalence of patients admitted to intensive care units (ICUs) with SARS-CoV-2 infection who were prescribed antibiotics is undetermined and might contribute to the increased global antibiotic resistance. This systematic review evaluates the prevalence of antibiotic prescribing in patients admitted to ICUs with SARS-CoV-2 infection using PRISMA guidelines. We searched and scrutinized results from PubMed and ScienceDirect databases for published literature restricted to the English language up to 11 May 2021. In addition, we included observational studies of humans with laboratory-confirmed SARS-CoV-2 infection, clinical characteristics, and antibiotics prescribed for ICU patients with SARS-CoV-2 infections. A total of 361 studies were identified, but only 38 were included in the final analysis. Antibiotic prescribing data were available from 2715 patients, of which prevalence of 71% was reported in old age patients with a mean age of 62.7 years. From the reported studies, third generation cephalosporin had the highest frequency amongst reviewed studies (36.8%) followed by azithromycin (34.2%). The estimated bacterial infection in 12 reported studies was 30.8% produced by 15 different bacterial species, and S. aureus recorded the highest bacterial infection (75%). The fundamental outcomes were the prevalence of ICU COVID-19 patients prescribed antibiotics stratified by age, type of antibiotics prescribed, and the presence of co-infections and comorbidities. In conclusion, more than half of ICU patients with SARS-CoV-2 infection received antibiotics, and prescribing is significantly higher than the estimated frequency of identified bacterial co-infection.
Airborne bacteria pose a potential risk to human health upon inhalation in the indoor environments of health care facilities. Airborne bacteria may originate from various sources, including patients, workers, and daily visitors. Hence, this study investigates the quantity, size, and identification of airborne bacteria indoors and outdoors of four Primary Health Care Centers (PHCC) in Doha, Qatar. Air samples were collected from the lobby, triage room, and outside environment of the centers, including, Qatar University (QU-HC), Al-Rayyan (AR-HC), Umm-Ghuwailina (UG-HC), and Old Airport (OA-HC) between August 2020 and March 2021, throughout both the hot and the cold seasons. Samples were collected using an Anderson six-stage cascade impactor. The mean of the total colony-forming units was calculated per cubic meter of air (CFU/m3). QU-HC had the lowest mean of total bacterial count compared with other centers in the indoor and outdoor areas with 100.4 and 99.6 CFU/m3, respectively. In contrast, AR-HC had the highest level, with 459 CFU/m3 indoors, while OA-HC recorded the highest bacterial concentration of the outdoor areas with a total mean 377 CFU/m3. In addition, 16S rRNA sequencing was performed for genera identification. Staphylococcus, Acinetobacter, Bacillus, and Pseudomonas were the four most frequently identified bacterial genera in this study. The abundance of airborne bacteria in the four health centers was higher in the cold season. About 46% of the total airborne bacterial count for three PHCC centers exceeded 300 CFU/m3, making them uncompliant with the World Health Organization’s (WHO) recommendation for indoor settings. Consequently, an IAQ standards should be shaped to establish a baseline for measuring air pollution in Qatar. Additionally, it is crucial to understand seasonal fluctuations better so that hospitals can avoid rising and spreading infection peaks.
Extensive antimicrobial usage in animal farming plays a prominent role in the antimicrobial resistance (AMR) crisis and is repeatedly highlighted as an area needing development under the 'One Health' approach. Alternative therapies such as microbiome products can be used as prophylaxis to help avoid infectious disease. However, a limited number of studies have focused on AMR-targeted microbiome products. We conducted this systematic review by using PRISMA guidelines to screen for literature that have evaluated food animals' health when administrated with microbiome products targeting antimicrobial resistance (AMR) or antibiotic-resistant genes (ARGs). We searched and examined studies from SCOPUS, Web of Science, Embase, and Science direct databases for studies published up to November 2021, restricted to the English language. The findings of this review showed that microbiome products have a promising capability to tackle specific AMR/ARGs coupled with animal's health and productivity improvement. Furthermore, our study showed that probiotics were the most favourable tested microbiome products, with the most targeted resistance being to tetracycline, macrolides, and beta-lactams. While microbiome products are promising alternatives to antibiotic prophylactics, there is a dearth of studies investigating their efficacy in targeting AMR. Thus, it is highly recommended to further investigate, develop, and improve the microbiome, to better understand their utility and circumvent their limitations.
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