Aim The aim of this study was to investigate the patterns and determinants of drug resistance to tuberculosis (TB) in a large population from Makkah, Saudi Arabia. Methods A retrospective, cross-sectional cohort study was conducted on all patients with TB who were referred to the National Tuberculosis Prevention Program in Makkah, Saudi Arabia, between January 2016 and September 2020. For each TB case, demographic data were collected in addition to the results of drug susceptibility testing (DST) for anti-TB drugs. The Statistical Package for Social Sciences (SPSS) software for Windows, version 23 (IBM Corporation, Armonk, NY, USA), was used for the statistical analysis. Results A total of 472 TB-confirmed cases were included in the analysis. The mean ± standard deviation of the age was 38.5 ± 17.7 years. The vast majority of patients were male (62.7%) and had pulmonary TB (91.7%). Only a small proportion of the patients with TB had diabetes mellitus (8.5%). Overall, the prevalence of monodrug-resistant TB ranged from 2.1% to 3.4%. Specifically, the prevalence of monodrug-resistant TB to isoniazid and streptomycin was ranked first and was equal to 3.4%. Pyrazinamide had the lowest prevalence of monodrug-resistant TB (2.1%). The prevalence of polydrug-resistant TB (PDR-TB) and multidrug-resistant TB (MDR-TB) was 1.5%. In the univariate analysis, sex (male) was the only sociodemographic factor that significantly correlated with a higher prevalence of MDR-TB. Conclusions This is the second study from Makkah to analyze the prevalence and associated risk factors of MDR-TB among patients from Makkah. Our data demonstrated that the prevalence of monodrug-resistant TB and MDR-TB was low (2.1%-3.4% and 1.5%, respectively). Diabetes mellitus was not a substantial factor correlated with a higher occurrence of MDR-TB. Additional epidemiologic studies are required to validate our results.

Background: Acinetobacter baumannii has emerged as an extremely disturbing pathogen for several institutions worldwide. It is common in hospital environments, and outbreaks of Acinetobacter infections classically arise in intensive care units (ICUs). This investigation aimed to describe the extensively drug-resistant Acinetobacter baumannii (XDRAB) outbreak, which occurred in the intensive care unit (ICU) of Al-Qatif central hospital, Saudi Arabia. Methodology: This is a cross-sectional study for all positive (XDRAB) reported cases in the ICU of Al-Qatif Central Hospital, Eastern region during August and September 2019. Investigation of cases was based on the patient’s files, charts, lab records, interviewing the infection prevention and control team of the hospital, and the directorate. Microbiological and environmental samples were collected and tested for XDRAB. Results: A total of nine patients tested positive. Eight of the cases were male, and only three of them were Non-Saudi. The age ranged from 21 to 82 years, the mean age was 48.6 ± 21.14 years, and the mean length of ICU stay was eight ± 5.75 days. The environmental samples and the swabs from the health care workers (HCW) hand results were negative for XDRAB. Eight of the nine affected patients were on a mechanical ventilator (OR 9.2, 95% CI:1.09-77.9, P = 0.029), and according to the control chart, there was a previous outbreak attack in early 2019. Conclusion: The ICU of Al-Qatif hospital experienced an XDRAB outbreak in August, and it continued till September 2019. There was a previous outbreak with the same organism early in the same year, which required a strong adherence to the control and prevention measures and further analytical studies to find out the reasons behind the recurrent XDRAB outbreak. Key Words: Acinetobacter baumannii, outbreak investigation, drug-resistance, Saudi Arabia.

Background: Hajj (i.e., pilgrimage) is one of the largest mass gatherings in the globe. It brings people from around the world into small confined areas, which facilitates the transmission of droplet infections, like influenza. Saudi Arabia requires all healthcare workers (HCWs) receive the influenza vaccine since they can transmit influenza among infected patients to un-infected patients, including high-risk groups. We sought to assess the commitment of the HCWs toward vaccination as well as the reasons for vaccine refusal. Methodology: A cross-sectional study was performed during Hajj season 2019 among HCWs in Al Mashaer, Makkah, Saudi Arabia. Anonymous, self-administered questionnaires were distributed to collect the information on demographic characteristics, vaccine uptake, and their attitudes and concerns towards receiving the vaccine. Results: A total of 760 completed questionnaires were received, with a response rate of 95%. Males represented (58%), and the average age (Mean±SD) was 36.7±7.65 years. More than half of participants (56%) were working in the primary Health Centers (PHCs), while (44%) were working in the hospitals. (93%) of the participants have received the vaccine before in their life. For the 2019 Hajj season, (76%) of them received the vaccine. Following the authority’s recommendation (74%) was the main reason for vaccination, 24% were not vaccinated before attending this Hajj, and 25% did not intend to take the vaccine in the future. Concerns about the vaccine side effects (46%) and misconceptions regarding its efficacy (44%) were the main barriers for vaccination refusal. Logistic regression analysis showed that the other health cadres, pharmacists, and working in hospitals were independently associated with vaccine avoidance in the 2019 Hajj. While for the future intention to take the vaccine, working in the hospitals, HCWs from the northern region, other health cadres, nurses, and pharmacists were independently associated with vaccine rejection. Conclusion: Despite the good uptake of the vaccine, there are still misconceptions about the efficacy of the vaccine and concerns about its side effects. Awareness programs are required to address those concerns, especially for younger staff, pharmacists, and other cadres. Higher vaccine uptake among healthcare workers will impact the vaccination of the general population. Key Words: Pilgrimage, Seasonal influenza vaccine, healthcare workers, Saudi Arabia.