{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T20:07:44Z","timestamp":1793045264985,"version":"4.5.0"},"reference-count":84,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T00:00:00Z","timestamp":1734998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Mass gatherings are associated with the spread of communicable diseases. Some studies have suggested that acquisition of antimicrobial resistance (AMR) may be associated with attendance at specific mass gatherings. This systematic review aimed to synthesise evidence on the association between attendance at mass gatherings and antimicrobial resistance (AMR) and assess the prevalence of AMR at mass gatherings. A literature search of the Cochrane, Medline, Scopus, and Embase databases was performed. Studies were included if they reported original data, involved mass gatherings, and reported AMR results. Of 5559 titles screened, 44 studies met the inclusion criteria, most of which (n = 40) involved religious mass gatherings. The heterogeneity of the studies precluded a meta-analysis, hence a narrative synthesis by organism was conducted. A significant increase in antibiotic-resistant Escherichia coli and Klebsiella pneumoniae was reported following Hajj, as was a rise in gastrointestinal carriage of extended-spectrum \u03b2-lactamase (ESBL) or carbapenemase genes. Carriage of Streptococcus pneumoniae isolates non-susceptible to one or more antibiotics was also shown to increase from pre-Hajj to post-Hajj. There appears to be an association between attendance at mass gatherings and the acquisition of some AMR phenotypes and genotypes in some significant human pathogens, including E. coli and S. pneumoniae.<\/jats:p>","DOI":"10.3390\/tropicalmed10010002","type":"journal-article","created":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T04:45:49Z","timestamp":1735015549000},"page":"2","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Antimicrobial Resistance Associated with Mass Gatherings: A Systematic Review"],"prefix":"10.3390","volume":"10","author":[{"given":"Linda Tong","family":"Pao","sequence":"first","affiliation":[{"name":"Sydney Children\u2019s Hospitals Network, Westmead, NSW 2145, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1669-1494","authenticated-orcid":false,"given":"Mohamed","family":"Tashani","sequence":"additional","affiliation":[{"name":"The Children\u2019s Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia"},{"name":"Discipline of Paediatrics & Child Health, The University of New South Wales, Kensington, NSW 2033, Australia"},{"name":"Department of Paediatrics, Faculty of Medicine, University of Tripoli, Tripoli 13275, Libya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1390-8013","authenticated-orcid":false,"given":"Catherine","family":"King","sequence":"additional","affiliation":[{"name":"Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, Australia"},{"name":"Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2286-5139","authenticated-orcid":false,"given":"Harunor","family":"Rashid","sequence":"additional","affiliation":[{"name":"The Children\u2019s Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia"},{"name":"Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9114-6694","authenticated-orcid":false,"given":"Ameneh","family":"Khatami","sequence":"additional","affiliation":[{"name":"Sydney Children\u2019s Hospitals Network, Westmead, NSW 2145, Australia"},{"name":"The Children\u2019s Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia"},{"name":"Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Ho, C.S., Wong, C.T.H., Aung, T.T., Lakshminarayanan, R., Mehta, J.S., Rauz, S., McNally, A., Kintses, B., Peacock, S.J., and de la Fuente-Nunez, C. 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