Pyoderma among Hajj Pilgrims in Makkah.

OBJECTIVE Bacterial skin infections have been considered as a possible health problem of the Hajj pilgrims. Significant increase in the rate of resistance to commonly used antibiotics against gram positive organisms has been observed. The present study was planned to obtain the microbiological profile of bacterial skin infections and their susceptibility to antimicrobials. METHODS Pyodermas were investigated clinically and bacteriologically by a prospective study conducted on patients attending the dermatology clinic at the King Faisal Hospital, Makkah, Kingdom of Saudi Arabia during 2 Hajj periods (2000 - 2001). RESULTS Of a total of 80 pyoderma patients, 52.5% were primary and 47.5% secondary. The leading cause of primary pyoderma was found to be impetigo in 28.8% cases, and of secondary pyoderma was infected eczema in 18.8% cases. Positive cultures were found in 87.5% cases. The organisms responsible for primary pyoderma were: Staphylococcus aureus (65.6%), Streptococcus pyogenes (28.1%) or both (6.4%) while in secondary pydermas were: Staphylococcus aureus (44.7%), Streptococcus pyogenes (15.8%), or both (18.4%), and gram negative bacilli (21.1%). The resistant pattern of antimicrobials against Staphylococcus aureus was as follows: penicillin 80.85%, tetracycline 10.6%, gentamicin 6.4%, erythromycin 4.3% and cotrimoxazole [corrected] 4.3%. Oxacillin and cephalothin were found least resistant (2.1%). CONCLUSION Pyoderma appeared as one of the common health hazard of our Hajj pilgrims. Penicillin and tetracycline are found ineffective in treating skin infections caused by Staphylococcus aureus while oxacillin is recommended as first line of treatment.