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.
Conclusion: Our study demonstrates the importance of assessing the bacteriology of ARS to help implement guidelines for proper treatment and prevention protocols during Hajj season.


Professor and Consultant Of otolaryngology head and neck Surgery, Faculty of Medicine, and director of the simulation center for medical education at the Umm Al-QuraUniversity , head of Ophthalmology and otolaryngology department , Faculty of Medicine at the Umm Al-Qura University . and a Reviewer and editor of the Pan Arab Juornal of Rhinology ( PARS ) .
Dr. Marglani is Canadian board certified in otolaryngology head and neck surgery, 2005 from Ottawah ,Canada .
He has fellowship in Rhinology ,Endoscopic sinus and skull base surgery ,Vancouver ,BC, Canada.
He published more than 30 scientific research papers in otolaryngology , infectious diseases, and sinuses diseases prevention , treatment methods in ENT surgery and surgical educational .