Infectious disease is one of the greatest causes of morbidity and mortality worldwide, and with the emergence of antimicrobial resistance, the situation is worsening. In order to prevent this crisis, antimicrobial resistance needs to be monitored carefully to control the spread of multidrug-resistant bacteria. Therefore, in this study, we aimed to determine the prevalence of infection caused by Klebsiella pneumoniae and investigate the antimicrobial profile pattern of K. pneumoniae in the last eleven years. This retrospective study was conducted in a tertiary hospital in Makkah, Saudi Arabia. Data were collected from January 2011 to December 2021. From 2011 to 2021, a total of 61027 bacterial isolates were collected from clinical samples, among which 14.7% (n = 9014) were K. pneumoniae. The antibiotic susceptibility pattern of K. pneumoniae revealed a significant increase in the resistance rate in most tested antibiotics during the study period. A marked jump in the resistance rate was seen in amoxicillin/clavulanate and piperacillin/tazobactam, from 33.6% and 13.6% in 2011 to 71.4% and 84.9% in 2021, respectively. Ceftazidime, cefotaxime, and cefepime resistance rates increased from 29.9%, 26.2%, and 53.9%, respectively, in 2011 to become 84.9%, 85.1%, and 85.8% in 2021. Moreover, a significant increase in the resistance rate was seen in both imipenem and amikacin, with an average resistance rate rise from 6.6% for imipenem and 11.9% for amikacin in 2011 to 59.9% and 62.2% in 2021, respectively. The present study showed that the prevalence and drug resistance of K. pneumoniae increased over the study period. Thus, preventing hospital-acquired infection and the reasonable use of antibiotics must be implemented to control and reduce antimicrobial resistance.

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Legionella pneumophila is an important pathogen and is involved in more than 95% of cases of severe atypical pneumonia. The current study focused on the ablution water in the grand mosque in Makkah as well as water tanks in hotels surrounding the holy mosque. A total of 100 water samples were collected from ablution water in the Haram and the hotels in the central area around the grand mosque and sent to the research laboratory of microbiology, Faculty of Medicine, University of Umm Al Qura. Samples were filtrated and inoculated onto buffer charcoal-yeast extract agar base and incubated at 37°C in a CO 2 incubator. The plates were examined after seven days of incubation. Isolated organisms were confirmed by using the "Microgen Legionella" (latex agglutination test). Out of the 100 water samples tested, 11 samples were positive for L. pneumophila. All positive water samples were from hotels water tanks. This indicates that this type of bacteria existing in the water sources. So requires further research to cover all sources of water to avoid an outbreak of this infection among the pilgrims. To avoid the possibility of this, constant maintenance of hotel water tanks regularly and the use of chlorine in specific proportions according to recommended specifications can help reduce the spread of these microbial infections.

Respiratory infection is one of the infections that can be transmitted in closed places due to the ease of transmission of pathogens from infected people to healthy people through droplets from coughing and sneezing, among these bacterial causes, Haemophilus influenza. Therefore, this study aimed to evaluate the prevalence of this type of bacteria among pilgrims coming from different geographical locations in the world and determine the antibiotic-resistant strains. Around 1226 nasopharyngeal swabs were collected from 613 pilgrims from several different nationalities before and after completing the Hajj. These specimens were cultivated on chocolate agar medium and the pathogens were identified according to Clinical Laboratory Standards Institute (CLSI) protocol and confirmed by an automated system machine (VITEK2). There is no H. influenzae was detected among pilgrims before performing Hajj and the rate of transmission of H. influenzae was 1% after performing Hajj. The most effective antibiotics against to H. influenza isolates from pilgrims was Rifampicin while all the isolates were resistant to ampicillin. The continuous monitorization of the rate of potentially pathogenic bacterial during the Hajj season is required in order to develop advanced strategies to confront any outbreak of any infectious disease among the pilgrims.