Copyright
©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Bacterial co-infection in patients with SARS-CoV-2 in the Kingdom of Bahrain
Nermin Kamal Saeed, Safaa Al-Khawaja, Jameela Alsalman, Safiya Almusawi, Noor Ahmed Albalooshi, Mohammed Al-Biltagi
Nermin Kamal Saeed, Safiya Almusawi, Noor Ahmed Albalooshi, Medical Microbiology Section, Pathology Department, Salmaniya Medical Complex, Manama 00000, Bahrain
Nermin Kamal Saeed, Safiya Almusawi, Microbiology Department, Royal College of Surgeons in Ireland - Bahrain, Manama 00000, Bahrain
Safaa Al-Khawaja, Jameela Alsalman, Infection Disease Unit, Department of Internal Medicine, Salmaniya Medical Complex, Ministry of Health, Kingdom of Bahrain, Manama 00000, Bahrain
Safaa Al-Khawaja, Jameela Alsalman, Department of Infectious Disease, Arabian Gulf University, Manama 00000, Bahrain
Mohammed Al-Biltagi, Department of Pediatrics, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 00000, Bahrain
Mohammed Al-Biltagi, Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 000000, Al Gharbia, Egypt
Author contributions: All the authors contributed equally to this work; Saeed NK planned the research and together with Al-Khawaja S, Alsalman J, Almusawi S, and Albalooshi NA performed the research; Al-Biltagi M analyzed the data and wrote the manuscript; all authors have read and approved the final manuscript.
Institutional review board statement: The study was approved by the National COVID-19 Research Team and Secondary Care Research Committee of Salmaniya Medical Complex, Ministry of Health, the Kingdom of Bahrain.
Informed consent statement: The study had no ethical consideration as it was a retrospective non-interventional study with no exposure to any patient data.
Conflict-of-interest statement: The authors declare no conflict of interests for this article.
Data sharing statement: The data that support the findings of this study are available from the corresponding author, [Al-Biltagi M], upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Mohammed Al-Biltagi, MD, PhD, Chairman, Professor, Department of Pediatrics, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Adliya, Block 328, Bldg 61, King abdulaziz Avenu, Manama 00000, Bahrain. mbelrem@hotmail.com
Received: January 16, 2021
Peer-review started: January 16, 2021
First decision: May 5, 2021
Revised: May 7, 2021
Accepted: May 19, 2021
Article in press: May 19, 2021
Published online: July 25, 2021
ARTICLE HIGHLIGHTS
Research background
The coronavirus (COVID-19) pandemic presents a significant challenge to health worldwide. Bacterial and Fungal co-infections increase the risk of morbidity and mortality in patients with COVID-19, in conjunction with more burden on healthcare resources.
Research motivation
With the increasing risk of mortality among patients with COVID-19, there is a solid need to study the different factors that could increase or decrease this risk. Therefore, recognition of co-infection in patients with COVID-19 is of utmost importance. It enables us to implement the appropriate management and proper control of antibiotic use, with effective delivery of antimicrobial stewardship. Therefore, the centres that provide care for patients with COVID-19 in the kingdom of Bahrain participated in the current research.
Research objectives
We aimed to study the microbiological profile and the bacterial antibiogram in patients with COVID-19 who needed admission to receive treatment in the main centres concerned with managing COVID-19 disease in the Kingdom of Bahrain.
Research methods
The study was a retrospective observational analysis of the microbiological profile of the patients admitted with confirmed COVID-19 disease to the different Ministry of Health COVID isolation and treatment centres in the Kingdom of Bahrain for nine months period from February 2020 to October 2020.
Research results
There was a significant increase in the number of bacterial and fungal co-infection over the study period. The most common isolated organisms were the gram-negative bacteria (mainly Klebsiella pneumoniae, Pseudomonas aeruginosa, multi-drug resistant Acinetobacter baumannii, and Escherichia coli), the gram-positive bacteria (mainly coagulase negative Staphylococci, Enterococcus faecium, Enterococcus faecalis, Staphylococcus aureus) and fungaemia (Candida galabrata, Candida tropicalis, Candida albicans, Aspergillus fumigatus, Candida parapsilosis, Aspergillus niger). The hospital-acquired infection formed 73.8%, 61.6%, 100% gram-negative, gram-positive, and fungaemia. Most of the hospital-acquired infection occurred in the second period with a higher death rate than community-acquired infections.
Research conclusions
Bacterial and fungal co-infections in patients admitted with confirmed COVID-19 disease pose higher morbidity and mortality risks than those without co-infections. Therefore, we should perform every effort to minimize these risks.
Research perspectives
We need to study bacterial resistance mechanisms among the patients infected with COVID-19 and have co-infection with resistant bacterial strains. We also need to study viral co-infection and its effects on morbidity and mortality. Finally, we should compare our data with the data from other countries to generalize the obtained results.
