The Emergence, Persistence, and Dissemination of Antimicrobial-Resistant Bacteria in Environmental Hajj Settings and Implications for Public Health

doi:10.3390/tropicalmed6010033

Review

. 2021 Mar 10;6(1):33.

doi: 10.3390/tropicalmed6010033.

The Emergence, Persistence, and Dissemination of Antimicrobial-Resistant Bacteria in Environmental Hajj Settings and Implications for Public Health

Jaffar A Al-Tawfiq^{1

2

3}, Ziad A Memish^{4

5

6}

Affiliations

¹ Specialty Internal Medicine and Quality Division, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia.
² Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
³ Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21093, USA.
⁴ Director Research and Innovation Center, King Saud Medical City, Ministry of Health, Riyadh 12746, Saudi Arabia.
⁵ Al-Faisal University, Riyadh 11533, Saudi Arabia.
⁶ Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.

PMID: 33802167
PMCID: PMC8005974
DOI: 10.3390/tropicalmed6010033

Review

The Emergence, Persistence, and Dissemination of Antimicrobial-Resistant Bacteria in Environmental Hajj Settings and Implications for Public Health

Jaffar A Al-Tawfiq et al. Trop Med Infect Dis. 2021.

. 2021 Mar 10;6(1):33.

doi: 10.3390/tropicalmed6010033.

Authors

Jaffar A Al-Tawfiq^{1

2

3}, Ziad A Memish^{4

5

6}

Affiliations

¹ Specialty Internal Medicine and Quality Division, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia.
² Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
³ Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21093, USA.
⁴ Director Research and Innovation Center, King Saud Medical City, Ministry of Health, Riyadh 12746, Saudi Arabia.
⁵ Al-Faisal University, Riyadh 11533, Saudi Arabia.
⁶ Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.

PMID: 33802167
PMCID: PMC8005974
DOI: 10.3390/tropicalmed6010033

Abstract

The emergence of antimicrobial resistance is causing the loss of what was once considered the miracle cure. The transmission of antimicrobial resistance during mass gathering is a potential threat in addition to other infectious diseases. Here, we review the English language literature on the rate and the acquisition of antimicrobial resistance during the Hajj. There is a variable incidence of methicillin-resistant Staphylococcus aureus, Escherichia coli, and Enterobacteriaceae. There had been no report of multi-drug-resistant Mycobacterium tuberculosis. Continued surveillance of antimicrobial resistance coupled with public health measures are needed to decrease the rate of emergence of resistance.

Keywords: Hajj; antimicrobial resistance; mass gathering.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
The number of the annual Hajj pilgrims per year 1996–2019.

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References

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1. Al-Tawfiq J.A., Rabaan A.A., Saunar J.V., Bazzi A.M. Antimicrobial resistance of gram-negative bacteria: A six-year longitudinal study in a hospital in Saudi Arabia. J. Infect. Public Health. 2020;13:737–745. doi: 10.1016/j.jiph.2020.01.004. - DOI - PubMed
1. Memish Z.A., Steffen R., White P., Dar O., Azhar E.I., Sharma A., Zumla A. Mass gatherings medicine: Public health issues arising from mass gathering religious and sporting events. Lancet. 2019;393:2073–2084. doi: 10.1016/S0140-6736(19)30501-X. - DOI - PMC - PubMed
1. Al-Tawfiq J.A., Gautret P., Benkouiten S., Memish Z.A. Mass Gatherings and the Spread of Respiratory Infections. Lessons from the Hajj. Ann. Am. Thorac. Soc. 2016;13:759–765. doi: 10.1513/AnnalsATS.201511-772FR. - DOI - PubMed

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[1] Shiadeh S.M.J., Pormohammad A., Hashemi A., Lak P. Global prevalence of antibiotic resistance in blood-isolated enterococcus faecalis and enterococcus faecium: A systematic review and meta-analysis. Infect. Drug Resist. 2019;12:2713–2725. doi: 10.2147/IDR.S206084. - DOI - PMC - PubMed

[2] Shiadeh S.M.J., Pormohammad A., Hashemi A., Lak P. Global prevalence of antibiotic resistance in blood-isolated enterococcus faecalis and enterococcus faecium: A systematic review and meta-analysis. Infect. Drug Resist. 2019;12:2713–2725. doi: 10.2147/IDR.S206084. - DOI - PMC - PubMed

[3] Xie R., Zhang X.D., Zhao Q., Peng B., Zheng J. Analysis of global prevalence of antibiotic resistance in Acinetobacter baumannii infections disclosed a faster increase in OECD countries. Emerg. Microbes Infect. 2018;7 doi: 10.1038/s41426-018-0038-9. - DOI - PMC - PubMed

[4] Xie R., Zhang X.D., Zhao Q., Peng B., Zheng J. Analysis of global prevalence of antibiotic resistance in Acinetobacter baumannii infections disclosed a faster increase in OECD countries. Emerg. Microbes Infect. 2018;7 doi: 10.1038/s41426-018-0038-9. - DOI - PMC - PubMed

[5] Al-Tawfiq J.A., Rabaan A.A., Saunar J.V., Bazzi A.M. Antimicrobial resistance of gram-negative bacteria: A six-year longitudinal study in a hospital in Saudi Arabia. J. Infect. Public Health. 2020;13:737–745. doi: 10.1016/j.jiph.2020.01.004. - DOI - PubMed

[6] Al-Tawfiq J.A., Rabaan A.A., Saunar J.V., Bazzi A.M. Antimicrobial resistance of gram-negative bacteria: A six-year longitudinal study in a hospital in Saudi Arabia. J. Infect. Public Health. 2020;13:737–745. doi: 10.1016/j.jiph.2020.01.004. - DOI - PubMed

[7] Memish Z.A., Steffen R., White P., Dar O., Azhar E.I., Sharma A., Zumla A. Mass gatherings medicine: Public health issues arising from mass gathering religious and sporting events. Lancet. 2019;393:2073–2084. doi: 10.1016/S0140-6736(19)30501-X. - DOI - PMC - PubMed

[8] Memish Z.A., Steffen R., White P., Dar O., Azhar E.I., Sharma A., Zumla A. Mass gatherings medicine: Public health issues arising from mass gathering religious and sporting events. Lancet. 2019;393:2073–2084. doi: 10.1016/S0140-6736(19)30501-X. - DOI - PMC - PubMed

[9] Al-Tawfiq J.A., Gautret P., Benkouiten S., Memish Z.A. Mass Gatherings and the Spread of Respiratory Infections. Lessons from the Hajj. Ann. Am. Thorac. Soc. 2016;13:759–765. doi: 10.1513/AnnalsATS.201511-772FR. - DOI - PubMed

[10] Al-Tawfiq J.A., Gautret P., Benkouiten S., Memish Z.A. Mass Gatherings and the Spread of Respiratory Infections. Lessons from the Hajj. Ann. Am. Thorac. Soc. 2016;13:759–765. doi: 10.1513/AnnalsATS.201511-772FR. - DOI - PubMed

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The Emergence, Persistence, and Dissemination of Antimicrobial-Resistant Bacteria in Environmental Hajj Settings and Implications for Public Health

Affiliations

The Emergence, Persistence, and Dissemination of Antimicrobial-Resistant Bacteria in Environmental Hajj Settings and Implications for Public Health

Authors

Affiliations

Abstract

Conflict of interest statement

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References

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