{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T20:06:43Z","timestamp":1775074003018,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.74566.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T00:00:00Z","timestamp":1653868800000}}],"reference-count":37,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T00:00:00Z","timestamp":1653868800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The authors declared that no grants were involved in supporting this work"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>\n                    <ns3:bold>Background:<\/ns3:bold>\n                    Diagnosis of co-infections with multiple pathogens among hospitalized coronavirus disease 2019 (COVID-19) patients can be jointly challenging and essential for appropriate treatment, shortening hospital stays and preventing antimicrobial resistance. This study proposes to investigate the burden of bacterial and fungal co-infections outcomes on COVID-19 patients. It is a single center cross-sectional study of hospitalized COVID-19 patients at Beit-Jala hospital in Palestine.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Methods:<\/ns3:bold>\n                    The study included 321 hospitalized patients admitted to the ICU between June 2020 and March 2021 aged \u226520 years, with a confirmed diagnosis of COVID-19 via reverse transcriptase-polymerase chain reaction assay conducted on a nasopharyngeal swab. The patient's information was gathered using graded data forms from electronic medical reports.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Results:<\/ns3:bold>\n                    The diagnosis of bacterial and fungal infection was proved through the patient\u2019s clinical presentation and positive blood or sputum culture results. All cases had received empirical antimicrobial therapy before the intensive care unit (ICU) admission, and different regimens during the ICU stay. The rate of bacterial co-infection was 51.1%, mainly from gram-negative isolates (\n                    <ns3:italic>Enterobacter<\/ns3:italic>\n                    species and\n                    <ns3:italic>K.pneumoniae<\/ns3:italic>\n                    ). The rate of fungal co-infection caused by\n                    <ns3:italic>A.fumigatus<\/ns3:italic>\n                    was 48.9%, and the mortality rate was 8.1%. However, it is unclear if it had been attributed to SARS-CoV-2 or coincidental.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Conclusions:<\/ns3:bold>\n                    Bacterial and fungal co-infection is common among COVID-19 patients at the ICU in Palestine, but it is not obvious if these cases are attributed to SARS-CoV-2 or coincidental, because little data is available to compare it with the rates of secondary infection in local ICU departments before the pandemic. Comprehensively, those conclusions present data supporting a conservative antibiotic administration for severely unwell COVID-19 infected patients. Our examination regarding the impacts of employing antifungals to manage COVID-19 patients can work as a successful reference for future COVID-19 therapy.\n                  <\/ns3:p>","DOI":"10.12688\/f1000research.74566.2","type":"journal-article","created":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T12:15:05Z","timestamp":1653912905000},"page":"30","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Bacterial and fungal co-infections among ICU COVID-19 hospitalized patients in a Palestinian hospital: a retrospective cross-sectional study"],"prefix":"10.12688","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9700-8532","authenticated-orcid":false,"given":"Hani A.","family":"Naseef","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ula","family":"Mohammad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9452-8871","authenticated-orcid":false,"given":"Nimeh","family":"Al-Shami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yousef","family":"Sahoury","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7771-5608","authenticated-orcid":false,"given":"Abdallah D.","family":"Abukhalil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mutaz","family":"Dreidi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim","family":"Alsahouri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Farraj","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2022,5,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"281-286","DOI":"10.1007\/s12098-020-03263-6","article-title":"A Review of Coronavirus Disease-2019 (COVID-19).","volume":"87","author":"T Singhal","year":"2020","journal-title":"Indian J. Pediatr."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"3413-3416","DOI":"10.1093\/jac\/dkaa350","article-title":"Implications of antibiotics use during the COVID-19 pandemic: Present and future.","volume":"75","author":"C Miranda","year":"2020","journal-title":"J. Antimicrob. Chemother."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"4185-4191","DOI":"10.1080\/07391102.2020.1772110","article-title":"Covid-19 induced superimposed bacterial infection.","volume":"39","author":"M Hendaus","year":"2020","journal-title":"J. Biomol. Struct. 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Infect."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"559-562","DOI":"10.1007\/s15010-020-01553-x","article-title":"Bacterial coinfection in critically ill COVID-19 patients with severe pneumonia.","volume":"49","author":"A Elabbadi","year":"2021 Jun","journal-title":"Infection."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"102-110","DOI":"10.1080\/23744235.2020.1839672","article-title":"Few bacterial co-infections but frequent empiric antibiotic use in the early phase of hospitalized patients with COVID-19: results from a multicentre retrospective cohort study in The Netherlands.","volume":"53","author":"Z Karami","year":"2021","journal-title":"Infect. Dis. 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Med."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1629-1636","DOI":"10.1128\/JVI.80.4.1629-1636.2006","article-title":"Respiratory viruses augment the adhesion of bacterial pathogens to respiratory epithelium in a viral species-and cell type-dependent manner.","volume":"80","author":"V Avadhanula","year":"2006 Feb 15","journal-title":"J. Virol."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1622-1629","DOI":"10.1016\/j.cmi.2020.07.016","article-title":"Bacterial co-infection and secondary infection in patients with COVID-19: a living rapid review and meta-analysis.","volume":"26","author":"B Langford","year":"2020 Jul 22","journal-title":"Clin. Microbiol. Infect."},{"key":"ref15","article-title":"Antibiotics and antimicrobial resistance in the COVID-19 era: Perspective from resource-limited settings.","author":"M Lucien","year":"2021","journal-title":"Int. J. Infect. 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Care."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"599-606","DOI":"10.1007\/s11046-020-00462-9","article-title":"Fungal Co-infections Associated with Global COVID-19 Pandemic: A Clinical and Diagnostic Perspective from China.","volume":"185","author":"G Song","year":"2020","journal-title":"Mycopathologia."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1372-1379","DOI":"10.1164\/rccm.202003-0543OC","article-title":"Clinical features of 85 fatal cases of COVID-19 from Wuhan: A retrospective observational study.","volume":"201","author":"Y Du","year":"2020","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"475-481","DOI":"10.1016\/S2213-2600(20)30079-5","article-title":"Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study.","volume":"8","author":"X Yang","year":"2020","journal-title":"Lancet Respir. Med."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"11-18","DOI":"10.1111\/ijlh.13229","article-title":"COVID-19 and the clinical hematology laboratory.","volume":"42","author":"J Frater","year":"2020","journal-title":"Int. J. Lab. Hematol."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"235-243","DOI":"10.1016\/j.cca.2020.06.008","article-title":"Value of leukocytosis and elevated C-reactive protein in predicting severe coronavirus 2019 (COVID-19): A systematic review and meta-analysis.","volume":"509","author":"T Yamada","year":"2020","journal-title":"Clin. Chim. Acta."},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n677","article-title":"Remote management of covid-19 using home pulse oximetry and virtual ward support.","volume":"372","author":"T Greenhalgh","year":"2021","journal-title":"BMJ."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"475-482","DOI":"10.1016\/j.cca.2020.08.019","article-title":"Laboratory findings in COVID-19 diagnosis and prognosis.","volume":"510","author":"A Pourbagheri-Sigaroodi","year":"2020 Nov","journal-title":"Clinica Chimica Acta; International Journal of Clinical Chemistry."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"235-243","DOI":"10.1016\/j.cca.2020.06.008","article-title":"Value of leukocytosis and elevated C-reactive protein in predicting severe coronavirus 2019 (COVID-19): a systematic review and meta-analysis.","volume":"509","author":"T Yamada","year":"2020 Oct 1","journal-title":"Clin. Chim. Acta."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1045-1056","DOI":"10.1002\/jmv.26389","article-title":"The effect of smoking on COVID-19 severity: A systematic review and meta-analysis.","volume":"93","author":"R Reddy","year":"2021","journal-title":"J. Med. Virol."},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01340-2020","article-title":"Current smoking is not associated with COVID-19.","volume":"55","author":"J Leung","year":"2020","journal-title":"Eur. Respir. J."},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1101\/2020.03.20.20039818","article-title":"Potential Factors for Prediction of Disease Severity of COVID-19 Patients.","author":"H Zhang","year":"2020"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"60-65","DOI":"10.1111\/ggi.14102","article-title":"COVID-19 in older adults: What are the differences with younger patients?.","volume":"21","author":"A G\u00f3mez-Belda","year":"2021","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"94-112","DOI":"10.1007\/s12015-020-10048-z","article-title":"An Assessment on Impact of COVID-19 Infection in a Gender Specific Manner.","volume":"17","author":"H Agrawal","year":"2021","journal-title":"Stem Cell Rev. Rep."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"36-47","DOI":"10.1159\/000512592","article-title":"Association of Sex, Age, and Comorbidities with Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis.","volume":"64","author":"M Biswas","year":"2021","journal-title":"Intervirology."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1869-1878","DOI":"10.1007\/s40520-020-01664-3","article-title":"Clinical characteristics, laboratory outcome characteristics, comorbidities, and complications of related COVID-19 deceased: a systematic review and meta-analysis.","volume":"32","author":"P Qiu","year":"2020","journal-title":"Aging Clin. Exp. Res."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1105-1113","DOI":"10.1111\/anae.15095","article-title":"Patient blood management during the COVID\u201319 pandemic: a narrative review.","volume":"75","author":"D Baron","year":"2020","journal-title":"Anaesthesia."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"763-773","DOI":"10.1007\/s10654-020-00678-5","article-title":"Anemia and iron metabolism in COVID-19: a systematic review and meta-analysis.","volume":"35","author":"P Taneri","year":"2020","journal-title":"Eur. J. Epidemiol."},{"key":"ref38","doi-asserted-by":"publisher","first-page":"13185-13193","DOI":"10.1096\/fj.202001807","article-title":"Rationale for the use of N-acetylcysteine in both prevention and adjuvant therapy of COVID-19.","volume":"34","author":"S De Flora","year":"2020","journal-title":"FASEB J."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/11-30\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/11-30\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/11-30\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T09:05:12Z","timestamp":1655456712000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/11-30\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,30]]},"references-count":37,"URL":"https:\/\/doi.org\/10.12688\/f1000research.74566.2","relation":{"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.134315.r139416","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.134315.r139417","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.134315.r139417","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.134315.r139416","asserted-by":"object"}],"has-preprint":[{"id-type":"doi","id":"10.1101\/2021.09.12.21263463","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,30]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/11-30\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.134315.r139416, Maher Khdour, Faculty of Pharmacy, Al-Quds University, Abu Dis, Palestinian Territory, 01 Jun 2022, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/11-30\/v2#referee-response-139416","order":0,"name":"referee-response-139416","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.134315.r139417, Hamza Maswade, College of Pharmacy, Qassim University, Buraydah, Saudi Arabia, 17 Jun 2022, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/11-30\/v2#referee-response-139417","order":1,"name":"referee-response-139417","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}