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The Gulf Cooperation Council Center for Infection Control (GCC-IC) has placed the emergence of antimicrobial resistance (AMR) on the top of its agenda for the past four years. The board members have developed the initial draft for the GCC strategic plan for combating AMR in 2014. The strategic plan stems from the WHO mandate to combat AMR at all levels. The need for engaging a large number of stakeholders has prompted the GCC-IC to engage a wider core of professionals in finalizing the plan. A multi-disciplinary group of more than 40 experts were then identified. And a workshop was conducted in Riyadh January 2015 and included, for the first time, representation of relevant ministries and agencies as well as international experts in the field. Participants worked over a period of two and a half days in different groups. International experts shared the global experiences and challenges in addressing human, food, animal, and environmental aspects of controlling AMR. Participants were then divided into 4 groups each to address the human, animal, microbiological and diagnostic, or the environmental aspect of AMR. At the end of the workshop, the strategic plan was revised and endorsed by all participants. The GCC-IC board members then approved it as the strategic plan for AMR. The document produced here is the first GCC strategic plan addressing AMR, which shall be adopted by GCC countries to develop country-based plans and related key performance indicators (KPIs). It is now the role of each country to identify the body that will be accountable for implementing the plan at the country level.

Objective: This article describes the situation analysis of endemic and emerging zoonoses, and includes prevention and control of zoonoses in Oman. It also suggests possible recommendations toward elimination and risk reduction of emerging zoonoses. Methods: Epidemiologic information has been drawn from official to assess the situation. There has been significant progress in reducing the risk of brucellosis, Middle East Respiratory Syndrome Coronavirus, Crimean-Congo hemorrhagic fever, and cutaneous leishmaniasis. Rabies, West Nile fever, Q fever, and cystic hydatid disease have been confined to wildlife or livestock. Results: There is an increasing threat of emerging and re-emerging zoonoses in Oman due to globalization of travel and trade, development activities, and impact of climate change and vector bionomics. Prevention, control, and subsequent elimination of zoonoses on a sustainable basis shall not be possible without intersectoral collaboration between the human and animal health sectors. There are challenges for establishing such strong collaboration and coordination mechanisms in Oman. Institutional and cultural barriers, data and resource sharing, and national capability for rapid and effective investigation of zoonotic infections and emerging zoonoses in humans and animal reservoirs are among others. Conclusions: In the light of achievements made on the prevention and control of zoonoses in Oman during the past decades, priority zoonoses should be identified for elimination, and continuous efforts should be made to further strengthen a holistic multidisciplinary and multisectorial approach for controlling zoonoses at source. Pivotal interventions would include urgent adoption of ''One Health'' strategic approach as well as establishment of a robust, integrated surveillance system with a strong laboratory investigation capacity to eliminate priority zoonoses and minimize the risk of entry, establishment, and spread of emerging zoonoses in Oman.

Background Bloodstream infections (BSI) are severe and challenging oncological complications, with a consequent high morbidity and mortality in the immunocompromised. We reviewed the profile and susceptibility of bacteria associated with infections in children under 13 years of age receiving chemotherapy. Methods Prospective cohort study of pediatric oncology patients was conducted between January 2015 and October 2017 at the Royal Hospital in Oman. Patient demographics, clinical data, laboratory parameters, microbial etiology and susceptibility, and outcomes were retrieved and analyzed. Results A total of 74 episodes of positive bacterial blood cultures were detected in 38 oncology patients (positive blood culture rate of 51%). Fifty-seven percent were positive for gram-negative organisms with Klebsiella (21%) being the most common gram-negative organism cultured, and the most common gram-positive organism was Staphylococcus (coagulase negative Staphylococcus (CONs) and S. Aureus ) (30%). The majority of patients had gastrointestinal complaints (74%), and almost half (51%) had prolonged periods of neutropenia (>7 days). One third of gram-negative organisms were resistant to four or more antibiotics with a major resistance of 31% to piperacillin-tazobactam. Of the gram-positive organisms, 38% were resistant to at least four antibiotics and 30% were pan-resistant (except for vancomycin). Conclusion The gram-negative organisms were dominant in BSIs with Klebsiella being the most common culprit. Bacteremia was prevalent, however, high resistance to first-line antibiotics was documented amongst gram-negative isolates, demanding strategies to ensure our patients’ safety.

Objectives Group B streptococcus (GBS) infection is a serious disease that continues to cause high morbidity and mortality. It is one of the leading cause of sepsis; particularly meningitis, in infants and young children all around the world. In this study, we aim to identify the incidence of GBS sepsis in Omani infants less than 3 months of age who were born at Royal Hospital and who presented with clinical sepsis and positive culture. In addition, we aim to describe the clinical presentation and complications noted on admission and then on follow-up visit. Methods This is an observational retrospective chart review study. It included all Omani infants (0–3 months) who were diagnosed to have GBS sepsis/meningitis from 2006 to 2016 at the Royal Hospital, Muscat, Sultanate of Oman. Results There were 83,000 live births in the Royal Hospital over a period of 10 years. Thirty-eight babies had culture proven GBS infection, with an overall incidence rate of neonatal GBS of 0.46 per 1000 live births with 95% confidence intervals. There were no significant variations in the annual rates of infection during the study period, ranging from around 1–7 cases per year. Additional 5 cases of GBS sepsis presented to Royal Hospital are either through Emergency Department or as referrals from other hospitals, giving us a total of 43 cases of proven GBS infections. Out of the 43 cases, 8 were born prematurely (19%), either before (<34 weeks, n = 2) or during (34–36 weeks, n = 6). Term babies were 35 out of 43 with percentage of 81% of the total. Three died, resulting in a case mortality of 7.0%. Conclusion Our GBS incidence is comparable to that of screened population internationally. At the time being, with the best available results, maternal screening might not seem cost effective in our current settings. A cost effective study is required before implemented a national screening programme in the Country. However, this research will definitely help in the process of any future plans of implantation of new guidelines, as it can be used as leading point for future prospective studies.