Gram-negative bacteria (GNB) represent a major source of morbidity worldwide. The antimicrobial resistance of GNB has recently increased worldwide, that led to using colistin to treat multidrug resistant (MDR) GNB infections. Annually, Saudi Arabia hosts mass religious occasions, where the risk of infectious disease transmission is very high. This review aimed to provide an update on the current prevalence and molecular epidemiology of colistin-resistant GNB locally. It also assessed the role of mass gatherings in triggering colistin resistance. Although colistin is still highly effective against GNB isolates locally, high colistin resistance has been identified among major GNB such as Acinetobacter baumannii and Klebsiella pneumoniae. Colistin resistance among certain MDR Escherichia coli clones, such as ST131, has recently emerged and this is alarming given the rapid global dissemination of this clone. Local data has shown the role of mass religious gatherings in triggering the acquisition of colistin resistance, which makes the screening of colistin resistance determinants very important to limit the spread of colistin resistant GNB between pilgrims.

革兰氏阴性菌 (GNB) 是全世界发病率的主要来源。GNB 的抗菌素耐药性最近在全球范围内有所增加，这导致使用粘菌素治疗多药耐药 (MDR) GNB 感染。每年，沙特阿拉伯都会举办大规模的宗教活动，传染病传播的风险非常高。本综述旨在提供有关本地耐粘菌素 GNB 的当前流行率和分子流行病学的最新信息。它还评估了群众集会在引发粘菌素耐药性方面的作用。尽管粘菌素对局部 GNB 分离株仍然非常有效，但已在主要 GNB 中发现了高粘菌素耐药性，例如鲍曼不动杆菌和肺炎克雷伯菌。某些 MDR 中的粘菌素耐药性最近出现了大肠杆菌克隆，例如 ST131，鉴于该克隆在全球范围内迅速传播，这令人担忧。当地数据表明，大规模宗教集会在触发获得粘菌素耐药性方面的作用，这使得筛选粘菌素耐药性决定因素对于限制对粘菌素耐药性 GNB 在朝圣者之间的传播非常重要。