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Haseeb, A.; Saleem, Z.; Faidah, H.S.; Saati, A.A.; Alqarni, A.; Iqbal, M.S.; Alghamdi, S.; Elrggal, M.E.; Algethamy, M.; Radwan, R.M.; et al. Antimicrobial Resistance with Infectious Diseases during Hajj. Encyclopedia. Available online: https://encyclopedia.pub/entry/48926 (accessed on 01 July 2024).
Haseeb A, Saleem Z, Faidah HS, Saati AA, Alqarni A, Iqbal MS, et al. Antimicrobial Resistance with Infectious Diseases during Hajj. Encyclopedia. Available at: https://encyclopedia.pub/entry/48926. Accessed July 01, 2024.
Haseeb, Abdul, Zikria Saleem, Hani Saleh Faidah, Abdullah A. Saati, Abdullmoin Alqarni, Muhammad Shahid Iqbal, Saleh Alghamdi, Mahmoud E. Elrggal, Manal Algethamy, Rozan Mohammad Radwan, et al. "Antimicrobial Resistance with Infectious Diseases during Hajj" Encyclopedia, https://encyclopedia.pub/entry/48926 (accessed July 01, 2024).
Haseeb, A., Saleem, Z., Faidah, H.S., Saati, A.A., Alqarni, A., Iqbal, M.S., Alghamdi, S., Elrggal, M.E., Algethamy, M., Radwan, R.M., Mahrous, A.J., Abuhussain, S.S.A., Khayyat, S.M., Ibrahim, K., Godman, B., & Sheikh, A. (2023, September 07). Antimicrobial Resistance with Infectious Diseases during Hajj. In Encyclopedia. https://encyclopedia.pub/entry/48926
Haseeb, Abdul, et al. "Antimicrobial Resistance with Infectious Diseases during Hajj." Encyclopedia. Web. 07 September, 2023.
Antimicrobial Resistance with Infectious Diseases during Hajj
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This entry is adapted from the peer-reviewed paper 10.3390/antibiotics12081299

Hajj pilgrimage is a large mass gathering global event that may facilitate the spread and emergence of various infectious diseases as well as antimicrobial resistance (AMR) in a local and global scenario. Planning and preparing for these public health issues is a challenging and complex process for the Kingdom of Saudi Arabia (KSA) health authorities. Despite multiple efforts for the prevention and treatment of infectious diseases through longtime funding in education and medical care, the prevalence of infectious disease is still high among Hajj pilgrims. The commonly observed infectious diseases during Hajj include respiratory tract infections (influenza and pneumonia), urinary tract infections and skin infections that may necessitate the use of antimicrobials. Beta-lactams are used as a first-line treatment for hospital acquired infections as well as community acquired infections due to their broad-spectrum activity. However, most of the bacterial isolates such as Staphylococcus spp., Pseudomonas spp. and E. coli are resistant to beta-lactams. Irrational use of antimicrobials, lack of infection prevention practices and suboptimal healthcare access further exacerbate the risk of spreading AMR among Hajj pilgrims.

antimicrobial resistance Hajj pilgrims COVID-19

1. Introduction

An appreciable number of pilgrims gather from across the world to attend religious events and festivals when they occur [1]. Such gatherings increase the risk of especially communicable diseases that pose challenges to healthcare authorities [2][3][4]. Mass gatherings have been reported to have a considerable impact on an individual’s health and subsequent implications on the host’s country infrastructure and economy [5][6][7][8]. These mass gatherings can result in the dissemination of multi-drug resistant (MDR) strains and the spread of antimicrobial resistance (AMR) on a global scale [3][9][10][11]. Intersectoral approaches, public health surveillance and global communication are required to mitigate the risks of emerging and re-emerging infectious diseases [12][13][14][15][16]. After the H1N1 influenza pandemic, the first virtual international conference was held in Jeddah, KSA, in 2010, where The Lancet Infectious Diseases Series on mass gatherings was introduced. The majority of the national and international medical experts participated in this conference to develop and modify the guidelines for the diagnosis, treatment and prevention of infectious diseases during mass gathering events [17].
The Hajj is one of the biggest religious events hosted by the Kingdom of Saudi Arabia (KSA) every year. One of the obligatory pillars of Islam, Hajj is a pilgrimage to Makkah which is must for every physically fit, healthy Muslim to perform once in a lifetime if he/she can afford it [18]. It is performed from the 8th to 12th of Dhul-Hujjah, the last month of Islamic calendar. Currently, over three million Muslims travel to Saudi Arabia every year to perform Hajj rituals from almost 184 countries [19]. Over-crowded accommodations make an ideal environment for the exacerbation of communicable diseases, many of which are preventable if proper precautionary measures are taken [20]. Pilgrims are at potential risk of acquiring communicable diseases via contaminated food or water, person-to-person contact and vector-borne and respiratory transmission of viruses [4][17][21][22][23].
Antimicrobial resistant pathogens are currently prevalent in KSA [24][25][26]. Hajj pilgrims therefore face the potential risk of acquiring or transmitting these pathogens during their stay in KSA and subsequently spread these pathogens on their return home. A systematic review reported the prevalence and increasing trend of resistant pathogens during Hajj which include methicillin resistant Staphylococcus aureus (MRSA), 3GC-Enterobacteriaceae, colistin-resistant bacteria and imipenem-resistant bacteria [27]. Several studies conducted between 2002 and 2012 documented that the prevalence of MRSA varied significantly across different countries ranging from 0.06% to 94% [27][28][29].

2. Pattern and Prevalence of Infectious Diseases during Hajj

Possible infectious disease patterns during the Hajj pilgrimage include endemic, exported and imported diseases [30]. Inappropriate sanitary facilities, shared shelters, poor hygiene and lack of portable water enhance the transmission of infectious microorganisms. These combined factors have resulted in multiple communicable diseases among pilgrims during Hajj as well as after their return to their home countries [30][31]. The presence of a large number of pilgrims from different regions of the world in a gathering can increase the risk of spreading infectious diseases across international borders including resistant strains [32]. Climate conditions and air pollution in Makkah also play an important role in the transmission of infectious diseases [33].
Respiratory tract infections (RTIs) have been the predominant health problem among Hajj pilgrims over the past 15 years [34]. The most common pathogens for RTIs are Klebsiella pneumoniae, Haemophilus influenzae, Coronavirus, Adenovirus, respiratory syncytial virus (RSV), Staphylococcus aureus and Streptococcus pneumoniae [35][36]. According to one estimate, approximately 90% of Hajj pilgrims develop at least one respiratory illness before their return home [37]. Influenza has been the most common respiratory illness among Hajj pilgrims, estimated to be 24,000 cases per year [38]. Pneumonia has been observed as the most common life-threatening respiratory illness among pilgrims attending Mina healthcare centers [39] and the leading cause of hospital admissions particularly in intensive care units (ICUs) [40]. Among viral infections, herpes simplex virus (HSV) and adenovirus infections are the most commonly reported. The recent COVID-19 pandemic has also been a serious public health issue globally including in the KSA [41][42]. The KSA took all precautionary measures to prevent the spread COVID-19 based on typical effective public health measures and was declared COVID-19-free until March 2nd, 2020, when the first COVID-19 case was reported as an Iranian pilgrim [43][44]. Since then, KSA, the host country of annual Hajj pilgrimage, started witnessing an increasing trend of COVID-19 cases [45].
Moreover, of equal concern, is that tuberculosis (TB) has been reported in three studies [46][47][48]. The spread and emergence of MDR-TB has further complicated the circumstances, leading to unfavorable therapy outcomes and imposing an economic burden on patients as well as healthcare systems [46][49]. It is challenging to assess the exact prevalence of TB among Hajj pilgrims due to limited comprehensive studies targeting this specific group. Consequently, it is essential that the health authorities in KSA seek to implement strategies in the future to help control TB. These could include enhanced surveillance, diagnostics and treatment programs.
Several studies have, as mentioned, also recently discussed the transmission and acquisition of AMR during Hajj. Among the resistant strains, New Delhi metallo-B-lactamase, extended-spectrum B-lactamase-producing pathogens, SHV-12-producing Salmonella typhi, CTX-M-producing Escherichia Coli, Streptococcus pneumoniae [30] and methicillin-resistant Staphylococcus aureus (MRSA) have frequently been reported in Gulf Cooperation Council (GCC) countries especially in KSA [50][51].

3. Patterns of Antimicrobial Use among Hajj Pilgrims

Pilgrims come from different regions of the world, including countries where antimicrobials are typically dispensed without a prescription, which contributes to the spread and emergence of resistance [52][53][54]. The purchasing of antimicrobials without a prescription is now less of an issue in KSA following tightening of the regulations and the potential for considerable fines for abuse [55]. One of the predominant factors in the dissemination of AMR among Hajj pilgrims is the irrational use of antimicrobials [11][30]. During the Hajj pilgrimage, both community-acquired and hospital-acquired infections may necessitate the use of antimicrobials. The selection of antimicrobials is determined by the specific type and severity of the infection. Beta-lactams and cephalosporins are commonly used antibiotics for hospital acquired infections which exhibit efficacy against a wide range of bacteria and are frequently utilized as first-line therapy [56]. However, glycopeptides, e.g., vancomycin, are increasingly being used for the treatment of serious infections caused by resistant pathogens such as MRSA [57]. Similarly, in the case of community-acquired infections, beta-lactams including amoxicillin are the most frequently prescribed antibiotics among outpatients [58]. Fluoroquinolones are also often prescribed for respiratory tract infections, including CAP as a first-line treatment [59]. Moreover, trimethoprim-sulfamethoxazole (TMP-SMX) and macrolides are also utilized for various infections such as respiratory, urinary and skin infections [60].
As reported in multiple studies, 34.9% of Australian pilgrims, 84% of Malaysian pilgrims, 17% of Pakistani pilgrims and 58.5% of Irani pilgrims received antimicrobials during Hajj [61][62][63][64]. In another study, 47.6% of French pilgrims received antimicrobials [65] where beta-lactams (35.0%), macrolides (11.4%) and cephalosporins (2.3%) were the most common antimicrobials given to French pilgrims [65]. A prospective point prevalence study conducted in two referral hospitals in Medina documented that 49.2% of returning Hajj pilgrims were prescribed antibiotics. This included piperacillin-tazobactam (88%), penicillin (20%) and amoxiclav (12%) among Hajj pilgrims [66]. Another study reported that Malaysian pilgrims suffering from community-acquired pneumonia (CAP) acquired during the pilgrimage received levofloxacin (44%), azithromycin (40.7%) and cefuroxime (23.1%) on their return home [67].

4. Interventions and Recommendations

4.1. Local and International Guidelines and Policies for Infection Prevention and Control

Infection prevention and control is a pivotal component of any healthcare system at a national as well international levels given rising rates of AMR and the implications [68][69][70]. Many infectious diseases as well as outbreaks are preventable if proper measures, including educational sessions regarding disease prevention and self-hygiene combined with prophylactic treatment including vaccines, are adopted by pilgrims before arrival to KSA [71]. Collaborative and well-coordinated efforts from all healthcare professionals (HCPs), as well as other key stakeholders and community groups, are needed to reduce future prevalence rates. To help with this, the KSA Ministry of Health provides up-to-date Hajj travel advice and health regulations through international public health organizations such as the Centers for Disease Control and Prevention (CDC), the WHO and Hajj travel agencies [20]. The WHO has published guidelines entitled “communicable disease alert and response for mass gathering” since June 2008 [72], with the recent COVID-19 pandemic focusing minds on key public health measures that can be introduced to stop the spread of infectious diseases. However, in view of continued concerns, it is recommended that Saudi Ministry of Health and public health officials should propose local guidelines for all stakeholders regarding infection prevention and control not for only future Hajj pilgrimages but also other mass gatherings.

4.2. Restricting the Number of Hajj Pilgrims

The Saudi mitigation plan appears to have successfully limited the spread of COVID-19 in KSA as well as contributed to global health security [73]. In 2020, KSA authorities allowed 1000 pilgrims residing within KSA to perform Hajj with strict compliance with infection control measures and public health protocols [74]. No confirmed cases of COVID-19 or notable public heath events were recorded during this Hajj season. On the basis of the successful outcomes from the 2020 Hajj experience, Saudi authorities decided to extend the number to 60,000 pilgrims in 2021, presenting the similar results to 2020’s experience [75]. The rate of upper respiratory tract infections (URTIs) was 11.6 cases per 100,000 in the recent study compared to 2200 cases per 100,000 in a previous report [73]. Furthermore, a notable decrease in the number of non-communicable diseases (68 cases per 100,000) was reported when compared to previous study that showed the prevalence rate of 1600 per 100,000 cases [73][76]. The appreciable reduction in the cases of particularly URTIs reflects the effectiveness of adopting health policies and public health measures to restrict the number of Hajj pilgrims thereby ensuring their health to perform Hajj as well as reducing the period of Hajj stay alongside strict implementation of social distancing policies [73][77].

4.3. Provision and Implementation of Adequate Healthcare Services

The KSA government provides over 1000 free healthcare facilities for all pilgrims during Hajj. The services include mass vaccination, outbreak investigation, environmental health services, infectious disease surveillance, mass administration of prophylactic medication and health education [78]. Interventions to cope with the dissemination of infectious diseases include non-pharmaceutical and pharmaceutical methods. Non-pharmaceutical methods include surveillance, wearing face masks, hand hygiene, social distancing, travel restrictions and respiratory etiquette, while pharmaceutical approaches include vaccination and the use of antimicrobials [79][80]. The strategies and policies should be introduced to improve vaccination coverage among all HCWs, and these strategies should be practiced by all healthcare facilities in Saudi Arabia [81].

Vaccination

Vaccination is the most effective way to prevent the acquisition and transmission of infectious diseases [82]. The WHO has estimated that approximately 2.5 million individuals are prevented from catching various infectious diseases through vaccination every year [83]. In addition, vaccines can not only protect individuals from serious disease but also unvaccinated individuals through the concept of herd immunity [84]. Moreover, several studies have supported the idea that administration of viral and bacterial vaccines help to control the emergence and spread of AMR [85][86][87]. Vaccine administration and acceptability can be promoted through the implementation of effective strategies including educating HCWs and pilgrims about vaccination as a prerequisite for acquiring a Hajj visa [19]. Such strategies are endorsed by the fact that the prevalence of influenza-like symptoms was lower in vaccinated pilgrims than in unvaccinated pilgrims [88].
In view of studies such as these, the Saudi Ministry of Health has recommended influenza and meningococcal vaccination as mandatory for all pilgrims entering KSA for the Hajj to reduce the risk of transmission of RTIs [89]. During the current COVID-19 pandemic, the Saudi healthcare authorities has also made COVID-19 vaccination a mandatory requirement for all pilgrims participating in Hajj rituals before leaving for KSA.

Hand Hygiene

Hand hygiene is one of the simple, primary and effective preventive measures recommended by various healthcare organizations for the prevention of cross-contamination of pilgrims especially during pandemics [90][91]. A survey of Australian and French pilgrims during 2013–2014 reported that 94% and 50% of their pilgrims, respectively, practiced various hand hygiene techniques including washing and sanitizing [19]. Generally, the use of alcoholic sanitizer is one of the essential hand hygiene practices to prevent infectious diseases. However, Muslim pilgrims are denied using them because alcohol is prohibited in Islam [92]. This is a concern as compliance with recommended hand hygiene was reported in US (67.2%) and Turkish (57%) pilgrims and was significantly associated with low risk of RTIs [93][94].

Social Distancing and Contact Avoidance

According to the CDC, social distancing and contact avoidance with people are the best ways to minimize the transmission of infectious diseases [95]. During the COVID-19 pandemic, whilst no Hajj pilgrimage was performed in 2020 apart from 1000 KSA residents, in 2021 the Saudi healthcare authorities allowed the return of pilgrims. However, there were restrictions regarding social distancing of approximately 5 feet during prayers in the mosques and holy sites [96]. According to multiple surveys conducted among the wider pilgrim community, 48% of Turkish, 73% of Australian, 82% of Arab and 86% of French pilgrims believed that contact avoidance with sick people was a key element that would have reduced the transmission of infections [19].

Face Masks

Proper utilization of face masks has proven an effective preventive strategy to curb the aerosol spread of airborne infectious diseases. The effectiveness of face masks depends on its type, design and quality [97][98]. A study reported that Malaysian pilgrims used N-95 masks and surgical masks performing Hajj rituals [98]. However, the effectiveness of N-95 masks over surgical masks among HCWs from the prevention of communicable diseases is still unknown [99].
A meta-analysis study documented that the wearing face masks did not reduce the chances of catching influenza in 2009 [100]. Conversely, a systematic review reported that the prevalence of COVID-19, SARS and influenza decreased by 96%, 74% and 45% respectively by wearing facemasks [101]. In April 2020, the CDC recommended the use of cloth face masks to curtail community-based transmission [102], which should be adhered to for future mass gatherings.

5. Impact of Antibiotic Prescribing Patterns during the COVID-19 Pandemic on AMR

The irrational use of antibiotics during the recent COVID-19 pandemic may result in the emergence of AMR through appreciable over-prescribing across sectors despite limited evidence of bacterial infections or co-infections [11][103][104][105][106][107][108]. Usually, a large proportion of Hajj pilgrims consists of older people with multiple chronic comorbidities. Currently, patients with COVID-19 may receive antimicrobials for two main reasons. Firstly, the symptoms of the bacterial infectious disease resemble COVID-19. However, in order to differentiate between viral and bacterial infection, the ratio of CRP (mg/L) to 2–5A synthetase (pmole/dL) × 10 is used as a differential index. The index values in viral infections ranged from 0 to 0.9 and were lower than the values in bacterial infections, which ranged from 3.9 to 50 [109]. Diagnostic tests may though not be that effective with detection and can be time-consuming when immediate therapy is required [110]. Secondly, patients with COVID-19 may have bacterial co-infections that require antimicrobial therapy; however, this is rare in practice [106][107][108][111].
Consequently, comprehensive data are still required to have a better understanding of the occurrence of co-infections and pathogens involved, alongside the impact of underlying patient risk factors. Furthermore, standardized definitions and diagnostic criteria should be used to perform an in-depth analysis of microbiological resistance and antimicrobial usage where diagnostic laboratory infrastructure exists [112]. However, in the meantime, guidelines based on the AWaRe Book can be used to guide patient management of infectious diseases based on the balance of risks and benefits to reduce inappropriate prescribing and dispensing of antibiotics [113][114].
This is especially important in regions where Gram-negative pathogens are resistant to carbapenems. Antimicrobials with less favorable safety profiles such as colistin, a ‘Reserve’ antibiotic, are recommended as empiric therapy for suspected Gram-negative infections [115]. This needs to be avoided in the future. Similarly in countries such as Pakistan, ‘Watch’ and ‘Reserve’ antibiotics are being routinely dispensed in the community without a prescription driving up resistance rates [53], which is a concern. On the other hand, if antimicrobial treatment is not tailored to local AMR prevalence, patients with co-infections may receive ineffective therapy, which results in increased mortality rates and healthcare costs [111]. This situation can be avoided by developing local guidelines based on the AWaRe book and subsequently monitoring antibiotic usage through antimicrobial stewardship programs [116][117][118].

References

  1. Yezli, S.; Alotaibi, B.M. Mass gatherings and mass gatherings health. Saudi Med. J. 2016, 37, 729.
  2. Coltart, C.E.; Behrens, R.H. The new health threats of exotic and global travel. Br. J. Gen. Pr. 2012, 62, 512–513.
  3. Saleem, Z.; Hassali, M.A. Travellers take heed: Outbreak of extensively drug resistant (XDR) typhoid fever in Pakistan and a warning from the US CDC. Travel Med. Infect. Dis. 2019, 27, 127.
  4. Hoang, V.-T.; Gautret, P. Infectious diseases and mass gatherings. Curr. Infect. Dis. Rep. 2018, 20, 44.
  5. Bokhary, H.; Rashid, H.; Hill-Cawthorne, G.A.; Abd El Ghany, M. The rise of antimicrobial resistance in mass gatherings. In Handbook of Healthcare in the Arab World; Springer: Berlin/Heidelberg, Germany, 2021; pp. 1199–1214.
  6. Shafi, S.; Azhar, E.; Al-Abri, S.; Sharma, A.; Merali, N.; Al-Tawfiq, J.A.; El-Kafrawy, S.A.; Zumla, A.; Lee, S.S. Infectious diseases threats at the Arba’een–a neglected but one of the largest annually recurring mass gathering religious events. Int. J. Infect. Dis. 2022, 123, 210–211.
  7. Lami, F.; Amiri, M.; Majeed, Y.; Barr, K.M.; Nsour, M.A.; Khader, Y.S. Real-time surveillance of infectious diseases, injuries, and chronic conditions during the 2018 Iraq Arba’een mass gathering. Health Secur. 2021, 19, 280–287.
  8. Sweileh, W.M. Health-related research publications on religious mass gatherings of Muslims: A bibliometric analysis (1980–2020). Trop. Dis. Travel Med. Vaccines 2022, 8, 1.
  9. Alshammari, S.M.; Gwalani, H.; Helsing, J.E.; Mikler, A.R. Disease spread simulation to assess the risk of epidemics during the global mass gathering of Hajj pilgrimage. In Proceedings of the 2019 Winter Simulation Conference (WSC), National Harbor, MD, USA, 8–12 December 2019; pp. 215–226.
  10. Haseeb, A.; Faidah, H.S.; Bakhsh, A.R.; Malki, W.H.A.; Elrggal, M.E.; Saleem, F.; Rahman, S.u.; Khan, T.M.; Hassali, M.A. Antimicrobial resistance among pilgrims: A retrospective study from two hospitals in Makkah, Saudi Arabia. Int. J. Infect. Dis. 2016, 47, 92–94.
  11. Haseeb, A.; Faidah, H.S.; Algethamy, M.; Alghamdi, S.; Alhazmi, G.A.; Alshomrani, A.O.; Alqethami, B.R.; Alotibi, H.S.; Almutiri, M.Z.; Almuqati, K.S. Antimicrobial Usage and Resistance in Makkah Region Hospitals: A Regional Point Prevalence Survey of Public Hospitals. Int. J. Environ. Res. Public Health 2022, 19, 254.
  12. Memish, Z.A.; Stephens, G.M.; Steffen, R.; Ahmed, Q.A.J.T.L.i.d. Emergence of medicine for mass gatherings: Lessons from the Hajj. Lancet Infect. Dis. 2012, 12, 56–65.
  13. Haseeb, A.; Faidah, H.S.; Al-Gethamy, M.; Iqbal, M.S.; Barnawi, A.M.; Elahe, S.S.; Bukhari, D.N.; Noor Al-Sulaimani, T.M.; Fadaaq, M.; Alghamdi, S. Evaluation of a Multidisciplinary Antimicrobial Stewardship Program in a Saudi Critical Care Unit: A Quasi-Experimental Study. Front. Pharmacol. 2021, 11, 2222.
  14. Haseeb, A.; Faidah, H.S.; Al-Gethamy, M.; Iqbal, M.S.; Alhifany, A.A.; Ali, M.; Abuhussain, S.S.A.; Elrggal, M.E.; Almalki, W.H.; Alghamdi, S.; et al. Evaluation of Antimicrobial Stewardship Programs (ASPs) and their perceived level of success at Makkah region hospitals, Kingdom of Saudi Arabia. Saudi Pharm. J. 2020, 28, 1166–1171.
  15. Degeling, C.; Johnson, J.; Kerridge, I.; Wilson, A.; Ward, M.; Stewart, C.; Gilbert, G. Implementing a One Health approach to emerging infectious disease: Reflections on the socio-political, ethical and legal dimensions. BMC Public Health 2015, 15, 1307.
  16. Saleem, Z.; Godman, B.; Azhar, F.; Kalungia, A.C.; Fadare, J.; Opanga, S.; Markovic-Pekovic, V.; Hoxha, I.; Saeed, A.; Al-Gethamy, M. Progress on the national action plan of Pakistan on antimicrobial resistance (AMR): A narrative review and the implications. Expert Rev. Anti-Infect. Ther. 2022, 20, 71–93.
  17. 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.
  18. Mantoro, T.; Aris, M.F.M.; Ayu, M.A. Hajjlocator: A hajj pilgrimage tracking framework in crowded ubiquitous environment. In Proceedings of the 2011 International Conference on Multimedia Computing and Systems, Ouarzazate, Morocco, 7–9 April 2011; pp. 1–6.
  19. Goni, M.D.; Hasan, H.; Wan-Arfah, N.; Naing, N.N.; Deris, Z.Z.; Arifin, W.N.; Baaba, A.A.; Aliyu, A.; Adam, B.M.J.F.i.p.h. Health Education Intervention as an Effective Means for Prevention of Respiratory Infections Among Hajj Pilgrims: A Review. Front. Public Health 2020, 8, 449.
  20. Shafi, S.; Dar, O.; Khan, M.; Khan, M.; Azhar, E.I.; McCloskey, B.; Zumla, A.; Petersen, E. The annual Hajj pilgrimage—Minimizing the risk of ill health in pilgrims from Europe and opportunity for driving the best prevention and health promotion guidelines. Int. J. Infect. Dis. 2016, 47, 79–82.
  21. Razavi, S.M.; Mardani, M.; Salamati, P. Infectious Diseases and Preventive Measures During Hajj Mass Gatherings: A Review of the Literature. Arch. Clin. Infect. Dis. 2018, 13, e62526.
  22. Almeleebia, T.M.; Alhifany, A.A.; Almutairi, F.; Alshibani, M.; Alhossan, A.M. Regulating antimicrobial sales in Saudi Arabia: Achievements and challenges. Int. J. Clin. Pract. 2021, 75, e13833.
  23. Petersen, E.; Memish, Z.A.; Zumla, A.; Al Maani, A. Transmission of respiratory tract infections at mass gathering events. Curr. Opin. Pulm. Med. 2020, 26, 197–202.
  24. Yezli, S.; Shibl, A.M.; Livermore, D.M.; Memish, Z.A. Prevalence and antimicrobial resistance among Gram-negative pathogens in Saudi Arabia. J. Chemother. 2014, 26, 257–272.
  25. Hadi, M.A.; Karami, N.A.; Al-Muwalid, A.S.; Al-Otabi, A.; Al-Subahi, E.; Bamomen, A.; Mohamed, M.M.A.; Elrggal, M.E. Community pharmacists’ knowledge, attitude, and practices towards dispensing antibiotics without prescription (DAwP): A cross-sectional survey in Makkah Province, Saudi Arabia. Int J Infect Dis. 2016, 47, 95–100.
  26. Zowawi, H.M.; Balkhy, H.H.; Walsh, T.R.; Paterson, D.L. β-Lactamase production in key gram-negative pathogen isolates from the Arabian Peninsula. Clin. Microbiol. Rev. 2013, 26, 361–380.
  27. Leangapichart, T.; Rolain, J.-M.; Memish, Z.A.; Al-Tawfiq, J.A.; Gautret, P. Emergence of drug resistant bacteria at the Hajj: A systematic review. Travel Med. Infect. Dis. 2017, 18, 3–17.
  28. Yousef, S.A.; Mahmoud, S.Y.; Eihab, M.T. Prevalence of methicillin-resistant Staphylococcus aureus in Saudi Arabia: Systemic review and meta-analysis. Afr. J. Clin. Exp. Microbiol. 2013, 14, 146–154.
  29. Nazeer, A.; Al-Tawfiq, J.A. Methicillin-resistant Staphylococcus aureus metrics for patients in Saudi Arabia. J. Infect. Dev. Ctries. 2012, 6, 223–233.
  30. Al-Tawfiq, J.; Memish, Z.J.C.M. Infection. Potential risk for drug resistance globalization at the Hajj. Clin. Microbiol. Infect. 2015, 21, 109–114.
  31. Leangapichart, T.; Gautret, P.; Griffiths, K.; Belhouchat, K.; Memish, Z.; Raoult, D.; Rolain, J.-M.J.A.A. Acquisition of a high diversity of bacteria during the Hajj pilgrimage, including Acinetobacter baumannii with blaOXA-72 and Escherichia coli with blaNDM-5 carbapenemase genes. Chemotherapy 2016, 60, 5942–5948.
  32. Shirah, B.H.; Zafar, S.H.; Alferaidi, O.A.; Sabir, A.M. Mass gathering medicine (Hajj Pilgrimage in Saudi Arabia): The clinical pattern of pneumonia among pilgrims during Hajj. J. Infect. Public Health 2017, 10, 277–286.
  33. Simpson, I.J.; Aburizaiza, O.S.; Siddique, A.; Barletta, B.; Blake, N.J.; Gartner, A.; Khwaja, H.; Meinardi, S.; Zeb, J.; Blake, D.R. Air quality in Mecca and surrounding holy places in Saudi Arabia during Hajj: Initial survey. Environ. Sci. Technol. 2014, 48, 8529–8537.
  34. Gautret, P.; Benkouiten, S.; Al-Tawfiq, J.A.; Memish, Z.A. Hajj-associated viral respiratory infections: A systematic review. Travel Med. Infect. Dis. 2016, 14, 92–109.
  35. van Doorn, H.R.; Yu, H. Viral respiratory infections. In Hunter’s Tropical Medicine and Emerging Infectious Diseases; Elsevier: Amsterdam, The Netherlands, 2020; pp. 284–288.
  36. Dauda Goni, M.; Hasan, H.; Naing, N.N.; Wan-Arfah, N.; Zeiny Deris, Z.; Nor Arifin, W.; Abubakar Baaba, A. Assessment of Knowledge, Attitude and Practice towards Prevention of Respiratory Tract Infections among Hajj and Umrah Pilgrims from Malaysia in 2018. Int. J. Environ. Res. Public Health 2019, 16, 4569.
  37. Alfelali, M.; Barasheed, O.; Badahdah, A.-M.; Bokhary, H.; Azeem, M.I.; Habeebullah, T.; Bakarman, M.; Asghar, A.; Booy, R.; Rashid, H. Influenza vaccination among Saudi Hajj pilgrims: Revealing the uptake and vaccination barriers. Vaccine 2018, 36, 2112–2118.
  38. Balkhy, H.H.; Memish, Z.A.; Bafaqeer, S.; Almuneef, M.A. Influenza a common viral infection among Hajj pilgrims: Time for routine surveillance and vaccination. J. Travel Med. 2004, 11, 82–86.
  39. Benkouiten, S.; Al-Tawfiq, J.A.; Memish, Z.A.; Albarrak, A.; Gautret, P. Clinical respiratory infections and pneumonia during the Hajj pilgrimage: A systematic review. Travel Med. Infect. Dis. 2019, 28, 15–26.
  40. Dzaraly, N.D.; Rahman, N.I.A.; Simbak, N.B.; Ab Wahab, S.; Osman, O.; Ismail, S.; Haque, M. Patterns of communicable and non-communicable diseases in Pilgrims during Hajj. Res. J. Pharm. Technol. 2014, 7, 12.
  41. Algaissi, A.A.; Alharbi, N.K.; Hassanain, M.; Hashem, A.M. Preparedness and response to COVID-19 in Saudi Arabia: Building on MERS experience. J. Infect. Public Health 2020, 13, 834–838.
  42. Shang, W.; Wang, Y.; Yuan, J.; Guo, Z.; Liu, J.; Liu, M. Global excess mortality during COVID-19 pandemic: A systematic review and meta-analysis. Vaccines 2022, 10, 1702.
  43. Shabrawishi, M.; Al-Gethamy, M.M.; Naser, A.Y.; Ghazawi, M.A.; Alsharif, G.F.; Obaid, E.F.; Melebari, H.A.; Alamri, D.M.; Brinji, A.S.; Al Jehani, F.H. Clinical, radiological and therapeutic characteristics of patients with COVID-19 in Saudi Arabia. PLoS ONE 2020, 15, e0237130.
  44. Ayouni, I.; Maatoug, J.; Dhouib, W.; Zammit, N.; Fredj, S.B.; Ghammam, R.; Ghannem, H. Effective public health measures to mitigate the spread of COVID-19: A systematic review. BMC Public Health 2021, 21, 1015.
  45. Atique, S.; Itumalla, R. Hajj in the Time of COVID-19. Infect. Dis. Health 2020, 25, 219–221.
  46. Sambas, M.F.M.K.; Rabbani, U.; Al-Gethamy, M.M.M.; Surbaya, S.H.; Alharbi, F.F.I.; Ahmad, R.G.A.; Qul, H.K.H.; Nassar, S.M.S.; Maddah, A.K.M.A.; Darweesh, B.A.K. Prevalence and determinants of multidrug-resistant tuberculosis in Makkah, Saudi Arabia. Infect. Drug Resist. 2020, 2020, 4031–4038.
  47. Al-Hayani, A.M.; Kamel, S.A.; Almudarra, S.S.; Alhayani, M.; Abu-Zaid, A.; Al-Hayani, A.; Kamel, S., Jr.; Al-Hayani, M.M. Drug resistance to anti-tuberculosis drugs: A cross-sectional study from Makkah, Saudi Arabia. Cureus 2021, 13, 8.
  48. Yezli, S.; Zumla, A.; Yassin, Y.; Al-Shangiti, A.M.; Mohamed, G.; Turkistani, A.M.; Alotaibi, B. Undiagnosed Active Pulmonary Tuberculosis among Pilgrims during the 2015 Hajj Mass Gathering: A Prospective Cross-sectional Study. Am. J. Trop. Med. Hyg. 2017, 97, 1304–1309.
  49. Yezli, S.; Memish, Z.A. Tuberculosis in Saudi Arabia: Prevalence and antimicrobial resistance. J. Chemother. 2012, 24, 1–5.
  50. Memish, Z.A.; Balkhy, H.H.; Almuneef, M.A.; Al-Haj-Hussein, B.T.; Bukhari, A.I.; Osoba, A. Carriage of Staphylococcus aureus among Hajj pilgrims. Saudi Med. J. 2006, 27, 1367.
  51. Al-Saleh, A.; Shahid, M.; Farid, E.; Bindayna, K. Trends in methicillin-resistant Staphylococcus aureus in the Gulf Cooperation Council countries: Antibiotic resistance, virulence factors and emerging strains. East. Mediterr. Health J. 2022, 28, 434–443.
  52. Zowawi, H.M. Antimicrobial resistance in Saudi Arabia: An urgent call for an immediate action. Saudi Med. J. 2016, 37, 935.
  53. Saleem, Z.; Hassali, M.A.; Godman, B.; Fatima, M.; Ahmad, Z.; Sajid, A.; Rehman, I.U.; Nadeem, M.U.; Javaid, Z.; Malik, M. Sale of WHO AWaRe groups antibiotics without a prescription in Pakistan: A simulated client study. J. Pharm. Policy Pract. 2020, 13, 1–8.
  54. Saleem, Z.; Hassali, M.A.; Hashmi, F.K.; Godman, B.; Saleem, F. Antimicrobial dispensing practices and determinants of antimicrobial resistance: A qualitative study among community pharmacists in Pakistan. Fam. Med. Community Health 2019, 7, e000138.
  55. Alrasheedy, A.A.; Alsalloum, M.A.; Almuqbil, F.A.; Almuzaini, M.A.; Aba Alkhayl, B.S.; Albishri, A.S.; Alharbi, F.F.; Alharbi, S.R.; Alodhayb, A.K.; Alfadl, A.A. The impact of law enforcement on dispensing antibiotics without prescription: A multi-methods study from Saudi Arabia. Expert Rev. Anti-Infect. Ther. 2020, 18, 87–97.
  56. Alyamani, E.J.; Khiyami, A.M.; Booq, R.Y.; Majrashi, M.A.; Bahwerth, F.S.; Rechkina, E. The occurrence of ESBL-producing Escherichia coli carrying aminoglycoside resistance genes in urinary tract infections in Saudi Arabia. Ann. Clin. Microbiol. Antimicrob. 2017, 16, 1.
  57. Marglani, O.A.; Alherabi, A.Z.; Herzallah, I.R.; Saati, F.A.; Tantawy, E.A.; Alandejani, T.A.; Faidah, H.S.; Bawazeer, N.A.; Marghalani, A.A.; Madani, T.A. Acute rhinosinusitis during Hajj season 2014: Prevalence of bacterial infection and patterns of antimicrobial susceptibility. Travel Med. Infect. Dis. 2016, 14, 583–587.
  58. Yezli, S.; Zaraa, S.; Yassin, Y.; Mushi, A.; Stergachis, A.; Khan, A. Medication utilization pattern among outpatients during the Hajj mass gathering. Saudi Pharm. J. 2020, 28, 1122–1128.
  59. Memish, Z.A.; Arabi, Y.M.; Ahmed, Q.A.; Shibl, A.M.; Niederman, M.S. Management and Prevention Strategies for Community-Acquired Pneumonia in the Gulf Corporation Council. J. Chemother. 2007, 19, 33–46.
  60. Alhifany, A.A.; Alqurashi, A.F.; Al-Agamy, M.H.; Alkhushaym, N.; Alhomoud, F.; Alhomoud, F.K.; Almangour, T.A. Employment of mapping technology in antimicrobial resistance reporting in Saudi Arabia. Geospat. Health 2020, 15, 1.
  61. Azeem, M.; Tashani, M.; Barasheed, O.; Heron, L.; Hill-Cawthorne, G.A.; Haworth, E.; Dwyer, D.E.; Rashid, H.; Booy, R. Knowledge, Attitude and Practice (KAP) Survey Concerning Antimicrobial Use among Australian Hajj Pilgrims. Infect Disord Drug Targets 2014, 14, 125–132.
  62. Mustafa, A.N.; Gessner, B.D.; Ismail, R.; Yusoff, A.F.; Abdullah, N.; Ishak, I.; Abdullah, N.; Merican, M.I. A case-control study of influenza vaccine effectiveness among Malaysian pilgrims attending the Haj in Saudi Arabia. Int. J. Infect. Dis. 2003, 7, 210–214.
  63. Metanat, M.; Sharifi-Mood, B.; Sanei-Moghaddam, S.; Rad, N.S. Pharyngeal carriage rate of Neisseria meningitidis before and after the Hajj pilgrimage, in Zahedan (southeastern Iran), 2012. Turk J. Med. Sci. 2015, 45, 1317–1320.
  64. Qureshi, H.; Gessner, B.D.; Leboulleux, D.; Hasan, H.; Alam, S.E.; Moulton, L.H. The incidence of vaccine preventable influenza-like illness and medication use among Pakistani pilgrims to the Haj in Saudi Arabia. Vaccine 2000, 18, 2956–2962.
  65. Hoang, V.-T.; Ali-Salem, S.; Belhouchat, K.; Meftah, M.; Sow, D.; Dao, T.-L.; Ly, T.D.A.; Drali, T.; Ninove, L.; Yezli, S. Respiratory tract infections among French Hajj pilgrims from 2014 to 2017. Sci. Rep. 2019, 9, 17771–17778.
  66. Yaser, M.; Aljabri, A.K.; Alsaadi, F.N.; Rizk, L.M.; Alahmadi, R.Y.; Aljuhani, S.R.; Aljohani, S.H.; Al Thagfan, S.S.; Alamuddin, W.A.; Alonazie, W.S. A prospective antibiotic point prevalence survey in two primary referral hospitals during and after pilgrims stay in Madinah, Saudi Arabia. Trop. J. Pharm. Res. 2020, 19, 391–399.
  67. Dzaraly, D.; Rahman, N.I.A.; Haque, M.; Ab Wahab, M.S.B.; Simbak, N.B.; Abd Aziz, A.; Ismail, S.; Muttalif, A.R.A. Antibiotic therapy of choice for community-acquired pneumonia in Malaysian Hajj pilgrims: The pattern and associated factors. Med. Stud. 2017, 33, 199–207.
  68. Murray, C.J.; Ikuta, K.S.; Sharara, F.; Swetschinski, L.; Aguilar, G.R.; Gray, A.; Han, C.; Bisignano, C.; Rao, P.; Wool, E. Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis. Lancet 2022, 399, 629–655.
  69. Dadgostar, P. Antimicrobial resistance: Implications and costs. Infect. Drug Resist. 2019, 12, 3903–3910.
  70. Minhas, S.; Kotwal, A.; Singh, M. Infection Control in Health Care Facilities. Med. J. Armed India 2011, 67, 7–8.
  71. Shafi, S.; Booy, R.; Haworth, E.; Rashid, H.; Memish, Z.A. Hajj: Health lessons for mass gatherings. J. Infect. Public Health 2008, 1, 27–32.
  72. Ahmed, Q.A.; Barbeschi, M.; Memish, Z.A. The quest for public health security at Hajj: The WHO guidelines on communicable disease alert and response during mass gatherings. Travel Med. Infect. Dis. 2009, 7, 226–230.
  73. Alahmari, A.A.; Khan, A.A.; Alamri, F.A.; Almuzaini, Y.S.; Alradini, F.A.; Almohamadi, E.; Alsaeedi, S.; Asiri, S.; Motair, W.; Almadah, A. Hajj 2021: Role of Mitigation Measures for Health Security. J. Infect. Public Health 2022, 15, 1350–1354.
  74. Jokhdar, H.; Khan, A.; Asiri, S.; Motair, W.; Assiri, A.; Alabdulaali, M. COVID-19 mitigation plans during Hajj 2020: A success story of zero cases. Health Secur. 2021, 19, 133–139.
  75. Basahel, S.; Alsabban, A.; Yamin, M. Hajj and Umrah management during COVID-19. Int. J. Inf. Technol. 2021, 13, 2491–2495.
  76. Alamri, F.A.; Khan, A.; Badokhan, A.H.; Abogazalah, F.N.; Alhraiwil, N.J.; Amer, S.A. Common Health Complains Among Pilgrims during Manasik El Hajj; Season 1439H (2018). Merit. Res. J. Med. Med. Sci. 2020, 8, 351–360.
  77. Aljohani, A.; Nejaim, S.; Khayyat, M.; Aboulola, O. E-government and logistical health services during Hajj season. Bull. Natl. Res. Cent. 2022, 46, 112.
  78. Memish, Z.A.; Zumla, A.; Alhakeem, R.F.; Assiri, A.; Turkestani, A.; Al Harby, K.D.; Alyemni, M.; Dhafar, K.; Gautret, P.; Barbeschi, M.J.T.L. Hajj: Infectious disease surveillance and control. Lancet 2014, 383, 2073–2082.
  79. Abolfotouh, M.A.; Almutairi, A.F.; Banimustafa, A.; Hagras, S.A.; Al Jeraisy, M. Behavior Responses and Attitude of the Public to COVID-19 Pandemic During Movement Restrictions in Saudi Arabia. Int. J. Gen. Med. 2021, 14, 741–753.
  80. Haworth, E.; Barasheed, O.; Memish, Z.A.; Rashid, H.; Booy, R. Prevention of influenza at Hajj: Applications for mass gatherings. J. R. Soc. Med. 2013, 106, 215–223.
  81. Haridi, H.K.; Salman, K.A.; Basaif, E.A.; Al-Skaibi, D.K. Influenza vaccine uptake, determinants, motivators, and barriers of the vaccine receipt among healthcare workers in a tertiary care hospital in Saudi Arabia. J. Hosp. Infect. 2017, 96, 268–275.
  82. Abd El Ghany, M.; Sharaf, H.; Hill-Cawthorne, G.A. Hajj vaccinations—Facts, challenges, and hope. Int. J. Infect. Dis. IJID Off. Publ. Int. Soc. Infect. Dis. 2016, 47, 29–37.
  83. Riedmann, E.M. Report: State of the Worlds Vaccines and Immunization; Taylor & Francis: Abingdon, UK, 2010.
  84. Andre, F.E.; Booy, R.; Bock, H.L.; Clemens, J.; Datta, S.K.; John, T.J.; Lee, B.W.; Lolekha, S.; Peltola, H.; Ruff, T. Vaccination greatly reduces disease, disability, death and inequity worldwide. Bull. World Health Organ. 2008, 86, 140–146.
  85. Dagan, R.; Klugman, K.P. Impact of conjugate pneumococcal vaccine on antibiotic resistance. Lancet Infect. Dis. 2008, 8, 369–385.
  86. Cohen, R. Approaches to reduce antibiotic resistance in the community. Pediatr. Infect. Dis. J. 2006, 25, 977–980.
  87. Kwong, J.C.; Maaten, S.; Upshur, R.E.; Patrick, D.M.; Marra, F. The effect of universal influenza immunization on antibiotic prescriptions: An ecological study. Clin. Infect. Dis. 2009, 49, 750–756.
  88. Hashim, S.; Ayub, Z.N.; Mohamed, Z.; Hasan, H.; Harun, A.; Ismail, N.; Rahman, Z.A.; Suraiya, S.; Naing, N.N.; Aziz, A.A. The prevalence and preventive measures of the respiratory illness among Malaysian pilgrims in 2013 Hajj season. J. Travel Med. 2016, 23, tav019.
  89. Badahdah, A.-M.; Alfelali, M.; Alqahtani, A.S.; Alsharif, S.; Barasheed, O.; Rashid, H.; the Hajj Research Team. Mandatory meningococcal vaccine, and other recommended immunisations: Uptake, barriers, and facilitators among health care workers and trainees at Hajj. World J. Clin. Cases 2018, 6, 1128.
  90. Prevention, I. Control of Epidemic-and Pandemic-Prone Acute Respiratory Infections in Health Care; World Health Organization: Geneva, Switzerland, 2014.
  91. Nieradko-Iwanicka, B. Hygiene–gold standard not only in prevention of COVID-19 infection. Reumatol./Rheumatol. Suppl. 2020, 58, 191.
  92. Ahmed, Q.A.; Memish, Z.A.; Allegranzi, B.; Pittet, D. Muslim health-care workers and alcohol-based handrubs. Lancet 2006, 367, 1025–1027.
  93. Balaban, V.; Stauffer, W.M.; Hammad, A.; Afgarshe, M.; Abd-Alla, M.; Ahmed, Q.; Memish, Z.A.; Saba, J.; Harton, E.; Palumbo, G. Protective practices and respiratory illness among US travelers to the 2009 Hajj. J. Travel Med. 2012, 19, 163–168.
  94. Sahin, M.K.; Aker, S.; Tuncel, E.K. Knowledge, attitudes and practices concerning Middle East respiratory syndrome among Umrah and Hajj pilgrims in Samsun, Turkey, 2015. Eurosurveillance 2015, 20, 30023.
  95. Sen-Crowe, B.; McKenney, M.; Elkbuli, A. Social distancing during the COVID-19 pandemic: Staying home save lives. Am. J. Emerg. Med. 2020, 38, 1519–1520.
  96. Sayed, A.A. The Progressive Public Measures of Saudi Arabia to Tackle COVID-19 and Limit Its Spread. Int. J. Environ. Res. Public Health 2021, 18, 783.
  97. Alghamdi, M.; Alotaibi, F.; Ahmed, H.; Alharbi, F.; Bukhari, O.; Youssef, A.-R. Effect of medical education on the knowledge, attitude and compliance regarding infection control measures among dental students in Makkah. J. Umm Al-Qura Univ. Med. Sci. 2021, 7, 14–17.
  98. Shahrul Anuwar, M.Y.; Imran, A.; Irfan, M. The issues of facemask among hajj pilgrims: A critical review. Int. J. Sci. Environ. Technol. 2014, 3, 1528–1534.
  99. Smith, J.D.; MacDougall, C.C.; Johnstone, J.; Copes, R.A.; Schwartz, B.; Garber, G.E. Effectiveness of N95 respirators versus surgical masks in protecting health care workers from acute respiratory infection: A systematic review and meta-analysis. CMAJ 2016, 188, 567–574.
  100. Saunders-Hastings, P.; Crispo, J.A.G.; Sikora, L.; Krewski, D. Effectiveness of personal protective measures in reducing pandemic influenza transmission: A systematic review and meta-analysis. Epidemics 2017, 20, 1–20.
  101. Liang, M.; Gao, L.; Cheng, C.; Zhou, Q.; Uy, J.P.; Heiner, K.; Sun, C. Efficacy of face mask in preventing respiratory virus transmission: A systematic review and meta-analysis. Travel Med. Infect. Dis. 2020, 36, 101751.
  102. Coclite, D.; Napoletano, A.; Gianola, S.; Del Monaco, A.; D’Angelo, D.; Fauci, A.; Iacorossi, L.; Latina, R.; La Torre, G.; Mastroianni, C. Face mask use in the Community for Reducing the Spread of COVID-19: A systematic review. Front. Med. 2020, 7, 594269.
  103. Getahun, H.; Smith, I.; Trivedi, K.; Paulin, S.; Balkhy, H.H. Tackling antimicrobial resistance in the COVID-19 pandemic. Bull. World Health Organ. 2020, 98, 442.
  104. Bednarčuk, N.; Golić Jelić, A.; Stoisavljević Šatara, S.; Stojaković, N.; Marković Peković, V.; Stojiljković, M.P.; Popović, N.; Škrbić, R. Antibiotic Utilization during COVID-19: Are We Over-Prescribing? Antibiotics 2023, 12, 308.
  105. Hsu, J. How COVID-19 is accelerating the threat of antimicrobial resistance. Bmj 2020, 369, m1983.
  106. Alshaikh, F.S.; Godman, B.; Sindi, O.N.; Seaton, R.A.; Kurdi, A. Prevalence of bacterial coinfection and patterns of antibiotics prescribing in patients with COVID-19: A systematic review and meta-analysis. PLoS ONE 2022, 17, e0272375.
  107. Langford, B.J.; So, M.; Raybardhan, S.; Leung, V.; Soucy, J.-P.R.; Westwood, D.; Daneman, N.; MacFadden, D.R. Antibiotic prescribing in patients with COVID-19: Rapid review and meta-analysis. Clin. Microbiol. Infect. 2021, 27, 520–531.
  108. Saleem, Z.; Haseeb, A.; Godman, B.; Batool, N.; Altaf, U.; Ahsan, U.; Khan, F.U.; Mustafa, Z.U.; Nadeem, M.U.; Farrukh, M.J. Point prevalence survey of antimicrobial use during the COVID-19 pandemic among different hospitals in Pakistan: Findings and implications. Antibiotics 2022, 12, 70.
  109. Sasaki, K.; Fujita, I.; Hamasaki, Y.; Miyazaki, S. Differentiating between bacterial and viral infection by measuring both C-reactive protein and 2′-5′-oligoadenylate synthetase as inflammatory markers. J. Infect. Chemother. 2002, 8, 76–80.
  110. Sproston, N.R.; Ashworth, J.J. Role of C-reactive protein at sites of inflammation and infection. Front. Immunol. 2018, 9, 754.
  111. Knight, G.M.; Glover, R.E.; McQuaid, C.F.; Olaru, I.D.; Gallandat, K.; Leclerc, Q.J.; Fuller, N.M.; Willcocks, S.J.; Hasan, R.; van Kleef, E.J.E. Antimicrobial resistance and COVID-19: Intersections and implications. Elife 2021, 10, e64139.
  112. Egyir, B.; Obeng-Nkrumah, N.; Kyei, G.B. COVID-19 pandemic and antimicrobial resistance: Another call to strengthen laboratory diagnostic capacity in Africa. Afr. J. Lab. Med. 2020, 9, 1302.
  113. Sharland, M.; Gandra, S.; Huttner, B.; Moja, L.; Pulcini, C.; Zeng, M.; Mendelson, M.; Cappello, B.; Cooke, G.; Magrini, N. Encouraging AWaRe-ness and discouraging inappropriate antibiotic use—The new 2019 Essential Medicines List becomes a global antibiotic stewardship tool. Lancet Infect. Dis. 2019, 19, 1278–1280.
  114. Sharland, M.; Zanichelli, V.; Ombajo, L.A.; Bazira, J.; Cappello, B.; Chitatanga, R.; Chuki, P.; Gandra, S.; Getahun, H.; Harbarth, S. The WHO essential medicines list AWaRe book: From a list to a quality improvement system. Clin. Microbiol. Infect. 2022, 28, 1533–1535.
  115. Almangour, T.A.; Alenazi, B.; Ghonem, L.; Alhifany, A.A.; Aldakheel, B.A.; Alruwaili, A. Inhaled colistin for the treatment of nosocomial pneumonia due to multidrug-resistant Gram-negative bacteria: A real-life experience in tertiary care hospitals in Saudi Arabia. Saudi Pharm. J. 2020, 28, 1009–1013.
  116. Nathwani, D.; Varghese, D.; Stephens, J.; Ansari, W.; Martin, S.; Charbonneau, C. Value of hospital antimicrobial stewardship programs : A systematic review. Antimicrob. Resist. Infect. Control 2019, 8, 1–13.
  117. Saleem, Z.; Godman, B.; Cook, A.; Khan, M.A.; Campbell, S.M.; Seaton, R.A.; Siachalinga, L.; Haseeb, A.; Amir, A.; Kurdi, A. Ongoing efforts to improve antimicrobial utilization in hospitals among African countries and implications for the future. Antibiotics 2022, 11, 1824.
  118. Siachalinga, L.; Mufwambi, W. Impact of antimicrobial stewardship interventions to improve antibiotic prescribing for hospital inpatients in Africa: A systematic review and meta-analysis. J. Hosp. Infect. 2022, 129, 124–143.
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Abdul Haseeb
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Abdullah A. Saati
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Abdullmoin AlQarni
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Muhammad Shahid Iqbal
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Saleh Alghamdi
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Mahmoud E. Elrggal
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Safa S. Almarzoky Abuhussain
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Sarah M. Khayyat
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Kiran Ibrahim
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