The prevalence ofLegionella pneumophiliain water systems of residential facilities in Kuwait was performed during the period from November 2007 to November 2011. A total of 204 water samples collected from faucets and showerheads in bathrooms (n= 82), taps in kitchens (n= 51), and water tanks (n= 71), from different locations of residential facilities in Kuwait were screened forLegionella pneumophilaby the standard culture method and by real time polymerase chain reaction (RT-PCR). Out of the 204 samples, 89 (43.6%) samples were positive forLegionellaspp., 48 (23.5%) samples were detected by the standard culture method, and 85 (41.7%) were detected by RT-PCR. Of the culture positiveLegionellasamples, counts ranged between 10 to 2250 CFU/L. Serological typing of 48Legionellaisolates revealed that 6 (12.5%) of these isolates belonged toLegionella pneumophilaserogroup 1, 37 (77.1%) isolates toLegionella pneumophilaserogroup 3, and 1 isolate each (2.1%) belonged to serogroups 4, 7, and 10. The minimum inhibitory concentration (MICs) of the 46 environmentalL. pneumophilaisolates against the 10 antimicrobials commonly used forLegionellainfection treatments were determined. Rifampicin was found to be the most active againstL. pneumophilaserogroups isolatesin vitro.

This study was conducted at one of the largest poultry companies in Kuwait during November and December 2019 to evaluate the microbiological threats of Escherichia coli (APEC), Salmonella spp., and Aspergillus fumigatus to chickens in fattening houses by counting and identifying the microorganisms by culturing and pyrosequencing analysis. During the fattening cycle, the temperature and humidity ranged between 23.6°C and 29°C and 64.1% and 87.1%, respectively. The total bacterial population and Aspergillus fumigatus measured in the indoor and outdoor air exhibited a linear relationship during the fattening cycle. The total bacterial and Aspergillus concentrations determined during the cycle ranged between 150 and 2000 CFU/m³ and 0 and 1000 CFU/m³, respectively. E. coli and Salmonella spp. concentrations determined during the cycle ranged between 1 and 220 CFU/m³ and 4 and 110 CFU/m³, respectively. Pyrosequencing analysis of the air inside the houses at the end of the cycle revealed extensive biodiversity in the microorganisms, detecting 32 bacterial genera and 14 species. The identified species belonging to the genera Corynebacterium, Haemophilus, Streptococcus, Veillonella, and Aspergillus were identified as potentially affecting human and broiler health. The emission of potentially pathogenic bacteria to the outdoor environment from chicken housing can pose a considerable risk to human health and environmental microbial pollution. This study could guide the development of integrated control devices for monitoring microbes in broiler production facilities during chicken collection for transport to slaughterhouses.

Kuwait has reported a problematic increase in the prevalence of Antimicrobial Resistance (AMR). However, the absence of studies that analyze AMR from combined human, agricultural (animal), and environmental domains limits our ability to assess the extent of the problem in Kuwait. Therefore, this systematic review provides a comprehensive insight into the AMR status in Kuwait regarding humans, agriculture (animals), and the environment from the perspective of the One Health approach. A systematic search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify the relevant literature on AMR in Kuwait. Multiple online electronic databases, including the Cochrane Library, Google Scholar, Web of Science, PubMed, BioMed Central (BMC), and Scopus, were searched to perform a narrative synthesis and meta-analysis. Twenty-eight studies published between 2009 and 2024 were included in this study. Domain-wise distribution varied, with 11 studies related to clinical settings, 11 to the environment, 4 to agricultural (animal), and 2 to both clinical and community settings. The narrative synthesis indicated a high occurrence of AMR bacteria in human, agriculture (animal), and environmental domains. In human domains, the dominant AMR isolates belonged to four Gram-negative species: E. coli, K. pneumoniae, P. aeruginosa, and Acinetobacter baumannii. In agriculture (animals), Salmonella isolates from poultry display high resistance to cefotaxime, ampicillin, and amoxicillin. Camel milk analyses revealed that 80% of bacterial isolates are resistant to antibiotics such as penicillin, tetracyclines, and carbapenems. An environmental analysis of sewage, seawater, sediment, and aerosol samples documented widespread antibiotic resistance genes (ARGs) with resistance mechanisms such as extended-spectrum beta-lactamase, carbapenemases, and colistin. The cross-domain analysis identified the overlapping of ARGs. Regarding the One Health approach, none of the studies used this approach to interlink these sectors. Meanwhile, the meta-analysis indicated a high resistance rate in humans (34.05%, 95% CI (22.81 to 46.27, p < 0.0001, I² = 98.94%)), agriculture (animals) (67.42%, 95% CI (30.30 to 94.93, p < 0.0001, I² = 97.40%)), and environment (69.86%, 95% CI (48.80 to 87.26, p < 0.0001, I² = 98.78%)). The reported spread of AMR and the overlap of resistance genes among isolates across the domains demonstrate the interconnected nature of AMR in Kuwait. These findings underscore the need to adopt the One Health approach to strengthen surveillance, implement control measures, and enhance public education strategies to address the complexity of AMR challenges in Kuwait.