title: Acute rhinosinusitis during Hajj season 2014: Prevalence of bacterial infection and patterns of antimicrobial susceptibility.
abstract: BACKGROUND
  The presence of large number of pilgrims during Hajj in Makkah region increases the risk of respiratory diseases. In this study, we aimed to assess the bacteriology of acute rhinosinusitis (ARS) during Hajj season and to demonstrate the antimicrobial susceptibility patterns that should guide the clinicians towards more appropriate antibiotic use.
  
  
  METHODS
  Patients with ARS presenting during Hajj season of 2014 were prospectively enrolled. According to EPOS2012 criteria. Sampling of sinus secretions was performed from the middle meatus adjacent to the maxillary sinus ostium via endoscopic guidance. Over all, the study has covered all ENT, emergency and outpatient departments in Hajj.
  
  
  RESULTS
  Two hundred and twenty six patients with ARS were enrolled in the study. Pathogenic bacteria were identified in 93 (41.2%) patients. Of the 93 patients with bacterial ARS, Staphylococcus aureus was isolated in 46 (49.5%) patients, out of which 13 (28.3%) were methicillin-resistant Staphylococcus aureus (MRSA).The second most common group of bacterial isolates was Enterobacteriaceae such as Escherichia coli, and various Klebsiella species. Antibiotic sensitivity showed that methicillin-sensitive Staphylococcus aureus (MSSA) was also sensitive to cephalosporins, quinolones and clindamycin, while exhibiting relatively less sensitivity rates to amoxicillin-clavulinic acid and macrolides.
  
  
  CONCLUSIONS
  Our study demonstrates the importance of assessing the bacteriology of ARS to help implement guidelines for proper treatment and prevention protocols during Hajj season.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Umm Al-Qura University, Makkah, Saudi Arabia; Ear, Nose, and Throat (ENT) Department, King Abdullah Medical City (KAMC), Makkah, Saudi Arabia. Electronic address: oamarglani@uqu.edu.sa.
authors.forename: Osama A
authors.initials: OA
authors.lastname: Marglani
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Umm Al-Qura University, Makkah, Saudi Arabia; Ear, Nose, and Throat (ENT) Department, King Abdullah Medical City (KAMC), Makkah, Saudi Arabia.
authors.forename: Ameen Z
authors.initials: AZ
authors.lastname: Alherabi
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Zagazig University, Egypt; Ear, Nose, and Throat (ENT) Department, King Abdullah Medical City (KAMC), Makkah, Saudi Arabia.
authors.forename: Islam R
authors.initials: IR
authors.lastname: Herzallah
authors.affiliation: Umm Al-Qura University, Makkah, Saudi Arabia.
authors.forename: Faisal A
authors.initials: FA
authors.lastname: Saati
authors.affiliation: Department of Medical Microbiology & Immunology, Faculty of Medicine, Zagazig University, Egypt.
authors.forename: Enas A
authors.initials: EA
authors.lastname: Tantawy
authors.affiliation: King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City National Guard Health Affairs, Saudi Arabia.
authors.forename: Talal A
authors.initials: TA
authors.lastname: Alandejani
authors.affiliation: Umm Al-Qura University, Faculty of Medicine Al- Noor Specialist Hospital, Laboratory and Blood Bank Department, Makkah, Saudi Arabia.
authors.forename: Hani S
authors.initials: HS
authors.lastname: Faidah
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Umm Al-Qura University, Makkah, Saudi Arabia.
authors.forename: Naif A
authors.initials: NA
authors.lastname: Bawazeer
authors.affiliation: Department of Preventive Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia.
authors.forename: Abdullah A
authors.initials: AA
authors.lastname: Marghalani
authors.affiliation: Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Tariq A
authors.initials: TA
authors.lastname: Madani
mesh_terms: D000208:Acute Disease / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification; D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D004755:Enterobacteriaceae / Q000187:drug effects / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007514:Islam; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015995:Prevalence; D012220:Rhinitis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D012852:Sinusitis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D014195:Travel; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antimicrobial susceptibility; Bacterial sinusitis; Rhinosinusitis