ABSTRACT
Background: Meningococcal disease and outbreaks are a risk during mass gatherings such as the Umrah religious pilgrimage to the Kingdom of Saudi Arabia (KSA). We aimed to investigate the carriage of Neisseria meningitidis among the 2019 Umrah pilgrims and determine the circulating serogroups and their antibiotic susceptibility profiles. Methods: We conducted a cross-sectional study among adult Umrah pilgrims from 17th to 29th April 2019 in Mecca city, KSA. A questionnaire was administered to each participant, and an oropharyngeal swab was obtained. Microbiological techniques were used to isolate, identify and serogroup N. meningitidis from the swabs. E-tests were used to determine the susceptibility of the isolates to nine antibiotics. Results: The study enrolled 616 pilgrims from 17 countries with a mean age of 53.8 years (±13.1, range = 19-91) and a male-to-female ratio of 1.1:1. Nearly 39% of the respondents had no formal education, 32.5% declared having an underlying health condition and 17.2% were current or past smokers. During their Umrah stay, most pilgrims reported sharing accommodation (98.5%) and never using a face mask (98.5%). Also, 34.6% reported suffering from influenza-like symptoms and 11.8% used antibiotics. N. meningitidis was isolated from three pilgrims (carriage rate of 0.49%), two were serogroup A and one was serogroup B. Antibiotic susceptibility results were available for one isolate (serogroup B) which showed resistance to ciprofloxacin and decreased susceptibility to trimethoprim-sulfamethoxazole. Conclusion: Carriage of N. meningitidis among Umrah pilgrims was low. However, invasive serogroups were identified, including an isolate resistant to ciprofloxacin used for chemoprophylaxis. Meningococcal disease preventive measures for Umrah should be regularly reviewed and updated accordingly to reduce the risk of the disease and future pilgrimage-associated outbreaks.
ABSTRACT
Microbiological contamination of food processing surfaces and utensils increases considerably the risk of food-borne illnesses via cross-contamination. Hence, the safety of served meals and beverages can be evaluated through the assessment of the microbiological quality of food contact surfaces in food-serving establishments. This study carried out in Makkah city aimed to assess the microbiological contamination levels on food processing surfaces and utensils in 43 restaurants from the 9 main districts in the city. A total of 294 swab preparations were taken from 16 types of food contact surfaces including cutting boards, food containers, knives, serving dishes and other utensils were examined. Ninety samples (31%) showed more than 10 CFU/cm2 which were considered positive for microbiological contamination. Meat chopping devices and cutting boards were found as the most contaminated food contact surfaces (60% and 50%), while washed serving dishes and fridge handles were the least contaminated (21% and 18%). Microorganisms detected in the study were Klebsiella spp. (18.7%), Escherichia coli (17,7%), Staphylococcus aureus (4,4%), Pseudomonas spp. (1.7%), Proteus spp. (0.7%), Bacillus cereus (0.7%), and Candida sp. (0.3%). Klebsiella spp. and E. coli were observed in at least one sample from each of the sixteen different food contact surfaces. The incidence of restaurants with contaminated food contact surfaces was significantly variable among the different districts, with a value as high as 57% in the most affected district and 20% in the less affected. No contamination with Salmonella spp. or Listeria spp. was detected, however, the detection of Bacillus cereus, a toxin-forming microorganism, in two different restaurants underlines the need for continuous microbiological assessment to ensure standard sanitation levels in restaurants and catering establishments of Makkah city.
