One of the public health issues faced worldwide is antibiotic resistance (AR). During the novel coronavirus (COVID-19) pandemic, AR has increased. Since some studies have stated AR has increased during the COVID-19 pandemic, and others have stated otherwise, this study aimed to explore this impact. Seven databases—PubMed, MEDLINE, EMBASE, Scopus, Cochrane, Web of Science, and CINAHL—were searched using related keywords to identify studies relevant to AR during COVID-19 published from December 2019 to May 2022, according to PRISMA guidelines. Twenty-three studies were included in this review, and the evidence showed that AR has increased during the COVID-19 pandemic. The most commonly reported resistant Gram-negative bacteria was Acinetobacterbaumannii, followed by Klebsiella pneumonia, Escherichia coli, and Pseudomonas aeruginosa. A. baumannii and K. pneumonia were highly resistant to tested antibiotics compared with E. coli and P. aeruginosa. Moreover, K. pneumonia showed high resistance to colistin. Commonly reported Gram-positive bacteria were Staphylococcus aureus and Enterococcus faecium. The resistance of E. faecium to ampicillin, erythromycin, and Ciprofloxacin was high. Self-antibiotic medication, empirical antibiotic administration, and antibiotics prescribed by general practitioners were the risk factors of high levels of AR during COVID-19. Antibiotics’ prescription should be strictly implemented, relying on the Antimicrobial Stewardship Program (ASP) and guidelines from the World Health Organization (WHO) or Ministry of Health (MOH).

This study was aimed at assessing the readiness of 200 emergency nurses in the southern part of Saudi Arabia in the management of public health emergencies, major incidents, and disasters by using quantitative research through a self-reporting validated questionnaire containing 10 different dimensions. All registered nurses working in emergency departments who were willing to participate, of all ages and gender groups, were included. Nurses who were not present during the study period because of vacation or maternity leave, nurses at the managerial level, and nursing aides were excluded. The participating nurses reported good knowledge in almost all investigated aspects of the theoretical dimensions of emergency management. However, they revealed perceived weaknesses in practical dimensions of emergency management and difficulties in assessing their own efforts. There was a significant correlation between qualification and the dimensions of emergency preparedness, epidemiology and surveillance, isolation and quarantine and critical resources, which indicates a need for strengthening their practical contribution as well as their theoretical knowledge. Educational initiatives combining theoretical and practical aspects of emergency management may provide an opportunity to examine nurses’ knowledge, skills, and abilities continuously in an environment with no harm to patients.

MERS is caused by a viral infection, which was first identified in KSA, 2012. MERS-CoV infection consequences with either hospitalization or death. All positive MERS-CoV cases that diagnosed in and reported to a referral hospital in Najran, KSA from March/2014 to December/2018 were revised retrospectively. We identified patients from infection control department and medical records. Demographic, clinical, and outcome data were collected. Of the 54 positive MERS-CoV cases, 3 cases were excluded because no available data. Therefore, the final number of the included cases in the study was 51 cases (94.4). Most of the patients were Saudi 36 (70.6%), and majority of cases were reported in the winter 18 (35.3) season. Fever 47 (92.2%), cough 44 (86.3%), and shortness of breath 37 (72.5%) were reported as most common symptoms. Most patients had diabetes mellitus and hypertension. Overall mortality rate was 37.3%, and interestingly the mortality rate dropped sharply over 5 years. In logistic regression analysis, Season and Chronic Kidney disease patients were the only two variables statistically significantly associated with death. The odds of death the patients infected by MERS-CoV during Autumn and Winter season were 4.09 times higher than those patients who infected during Spring and Summer season (OR = 4.09, CI 1.18-14.15, P < 0.026). Compared with MERS-CoV patients who had Non-Chronic kidney diseases, the odds of death the MERS-CoV patients who had chronic kidney diseases were 18.08 times higher (OR = 18.08, CI -2.01-162.99, P < 0.01). The case fatality rate of MERS-CoV infection was high. Further studies with large sample sizes are needed to explore the reasons behind the decrease in the mortality rate over the time period.

Medical research plays a crucial role in advancing the treatment and prevention of diseases, in addition to enhancing public health. This study aims to assess knowledge, attitude, and practice (KAP) of healthcare providers (HCPs) in relation to medical research, identify motivating factors and barriers that prevent them from conducting research, and identify associated factors with good knowledge, practice and positive attitude. In this cross-sectional study, a validated questionnaire was employed to gather data of HCPs who work at healthcare institutions affiliated with MOH. The Proportionate stratified random sampling method was used to recruit HCPS. Proportion (%), and median and interquartile range (IQR) were used to represent the data. Logistic regression analysis was carried out to identify associated factors with good knowledge, positive attitude, and good practice. A total of 285 HCPs were included in the analysis. The median score for knowledge was 43%, with scores ranging from 14 to 57%, for most participants showing variability in their knowledge levels. For attitude, the median score was 100%, indicating a generally positive outlook, with scores between 80% and 100% for most participants. The practice score had a median of 59%, with scores ranging from 33 to 83%, showing a wide range in research activity among the HCPS. The most reported motivators were strength of the resume (91.80%) and fulfilment of work requirements (90.80%). The most reported barriers were lack of financial support (82.3%), poor time management (78.7%), no enough research facilities (75.2%), lack of motivation (74.8%), inadequate skills and knowledge (72.3%), and lack of rewards (71.6%). Good knowledge was significantly associated with taken research methodology course (p. value = 0.001) and qualification (p. values = < 0.05). Positive attitude was significantly associated with workplace and qualification. Nationality (p. value = 0.005) and taking a research methodology course (p. value = 0.001) were significantly associated with good practice. Although HCPs showed a positive attitude towards medical research, their knowledge and practice were inadequate. They are necessarily needed for amelioration. This improvement can be achieved through effective and regular research methodology courses, workshops, and enhancement of the research environment.

Introduction: Prevalence of antibiotic resistance (AR) during the coronavirus 2019 (COVID-19) pandemic was higher than pre-pandemic times. This study determined the prevalence and patterns of AR among Gram-positive and negative bacteria before, during and after COVID-19 in Saudi Arabia and identified the associated factors. Methodology: A retrospective cross-sectional study was employed to identify patients with positive AR bacteria between March 2019 and March 2022. The bacterial isolates and patients’ data were identified from laboratory and medical records departments retrospectively. Binary logistic regression analysis was performed to identify the factors associated with AR and deaths. Multinominal logistic regression was applied to confirm the factors associated with AR classification. Results: AR Gram-negative bacteria decreased during and after the pandemic. However, S. aureus showed a negligible increase in resistance rate after pandemic, while E. faecium, recorded a higher-than-average resistance rate during the pandemic. The prevalence of pan drug resistance (PDR) during the pandemic (85.7%) was higher than before (0%) and after (14.3%), p = 0.001. The length of stay and time were significant predictors for AR classification. The odds of multi drug resistance (MDR) development to PDR during the pandemic were 6 times higher than before and after (OR = 6.133, CI =, p = 0.020). Age, nationality, COVID-19 infection, smoking, liver disease, and type and number of bacteria were associated with death of patients with positive AR. Conclusions: Further studies are recommended to explore the prevalence of PDR and to justify the increased rates of E. faecium AR during the COVID-19 pandemic.

Purpose: To evaluate the healthcare workers’ (HCWs) knowledge towards Nipah virus and identify the associated variables with good knowledge. Methods: A cross-sectional design was conducted in Najran, Kingdom of Saudi Arabia (KSA) to evaluate the knowledge of HCWs towards Nipah virus. A validated questionnaire was employed to collect the data of HCWs. It consisted of two parts: Socio-demographic characteristics of the participants and questions related to the knowledge towards Nipah virus. Percentages and median (Q1, Q3) were used to present the data and were compared by Mann–Whitney and Kruskal Wallis. The associated variables with good knowledge were identified by logistic regression. Results: The study included 247 participants. The median (Q1, Q3) knowledge score was 45% (10%, 60%), reflecting poor knowledge. About 62% of the HCWs stated that the symptoms of Nipah virus infection could be acute respiratory distress, convulsions, and coma. Only 36.8% reported no available vaccine to prevent Nipah virus infection, and more than 50% identified the virus’s main reservoir (fruit bat) as the possibility of transmission from animal to human. Roughly 57% of them reported that the virus can be transmitted among people through droplets. Less than 40% stated the Nipah virus can cause AIDS. The significantly associated variable with good knowledge was only nationality. Conclusion: The present study showed a poor knowledge of HCWs. Good knowledge was associated with nationality. Therefore, the implementation of education and training programmes are highly recommended throughout conducting prospective and interventional studies.