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<p>Mass gatherings (MGs), such as Hajj and Umrah, gather vast and diverse populations and potentially contribute to antimicrobial resistance (AMR) in the host country. However, assessing this impact is challenging due to the lack of a suitable baseline. During the COVID-19 pandemic restrictions and lifting, 185 sewage samples were collected from four wastewater treatment plants affected by MG and a control wastewater treatment plant, covering 3 Hajj seasons and 2 Ramadan periods. Here we show that despite no overall increase in total antibiotic resistance gene level, metagenomic analysis revealed that MGs introduced antibiotic resistance genes, including <i>bla</i><sub>PER</sub>, into the local sewage. This gene was also found in a genomic island facilitated by the IS<i>26</i> array, which was identified in viable opportunistic pathogens, including <i>Shewanella putrefaciens</i>, <i>Shewanella xiamenesis</i> and <i>Aeromonas media</i>, indicating emerging AMR threats to the local environment. These insights are crucial for informing public health strategies and interventions, ensuring better preparedness and response to AMR dissemination during MGs.</p>

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Wastewater surveillance unveils the impact of mass gatherings on antimicrobial resistance after the COVID-19 pandemic in Saudi Arabia

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月11日

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  • Changzhi Wang,
  • Yevhen Myshkevych,
  • Tiannyu Wang,
  • Mohammad Khalil Monjed,
  • Pei-Ying Hong

摘要

Mass gatherings (MGs), such as Hajj and Umrah, gather vast and diverse populations and potentially contribute to antimicrobial resistance (AMR) in the host country. However, assessing this impact is challenging due to the lack of a suitable baseline. During the COVID-19 pandemic restrictions and lifting, 185 sewage samples were collected from four wastewater treatment plants affected by MG and a control wastewater treatment plant, covering 3 Hajj seasons and 2 Ramadan periods. Here we show that despite no overall increase in total antibiotic resistance gene level, metagenomic analysis revealed that MGs introduced antibiotic resistance genes, including blaPER, into the local sewage. This gene was also found in a genomic island facilitated by the IS26 array, which was identified in viable opportunistic pathogens, including Shewanella putrefaciens, Shewanella xiamenesis and Aeromonas media, indicating emerging AMR threats to the local environment. These insights are crucial for informing public health strategies and interventions, ensuring better preparedness and response to AMR dissemination during MGs.