Doudou Sow1, Fabiola Dogue2, Sophie Edouard2, Tassadit Drali2, Ségolène Prades2, Emilie Battery2, Saber Yezli3, Badriah Alotaibi3, Cheikh Sokhna2, Didier Raoult2, Philippe Parola2, Philippe Gautret4. 1. Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France; Service de Parasitologie-Mycologie, Faculté de médecine, Unversité Cheikh Anta Diop, Dakar, Senegal. 2. Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France. 3. The Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia. 4. Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France. Electronic address: philippe.gautret@ap-hm.fr.
Abstract
BACKGROUND: Diarrhea can be frequent among Hajj pilgrims; however, data on its etiology are very limited. PATIENTS AND METHODS: A prospective cohort study was conducted among Hajj pilgrims in 2016. Medical follow-up and systematic rectal swabing were performed before leaving France and before leaving Saudi Arabia. Potential pathogens were identified using the BioFire FilmArray® Gastrointestinal multiplex qualitative PCR panel. RESULTS: 117 pilgrims were included and 13.7% experienced diarrhea during Hajj. Of the pre-Hajj samples, 32.5% were positive for at least one pathogen compared to 50% of post-Hajj samples (p = 0.0033). Diarrhea associated Escherichia coli strains, notably enteropathogenic E. coli (EPEC), enteroaggregative E. coli (EAEC), and Shiga-like toxin-producing E. coli, were acquired by 29.9%, 10.2%, and 6.5% pilgrims, respectively. Pilgrims with resolved diarrhea were significantly more likely to have post-Hajj EAEC positive samples, compared with those who did not suffer diarrhea (55.6% vs 16.5%). We found a lower prevalence of EPEC (22.5%) in pilgrims who declared washing their hands more frequently at the Hajj than usually as compared to others (40.0%). CONCLUSION: The acquisition of diarrhea associated E coli by Hajj pilgrims is of major concern given the high prevalence rate of third-generation cephalosporin-resistant E. coli in Saudi Arabia.
BACKGROUND:Diarrhea can be frequent among Hajj pilgrims; however, data on its etiology are very limited. PATIENTS AND METHODS: A prospective cohort study was conducted among Hajj pilgrims in 2016. Medical follow-up and systematic rectal swabing were performed before leaving France and before leaving Saudi Arabia. Potential pathogens were identified using the BioFire FilmArray® Gastrointestinal multiplex qualitative PCR panel. RESULTS: 117 pilgrims were included and 13.7% experienced diarrhea during Hajj. Of the pre-Hajj samples, 32.5% were positive for at least one pathogen compared to 50% of post-Hajj samples (p = 0.0033). Diarrhea associated Escherichia coli strains, notably enteropathogenic E. coli (EPEC), enteroaggregative E. coli (EAEC), and Shiga-like toxin-producing E. coli, were acquired by 29.9%, 10.2%, and 6.5% pilgrims, respectively. Pilgrims with resolved diarrhea were significantly more likely to have post-Hajj EAEC positive samples, compared with those who did not suffer diarrhea (55.6% vs 16.5%). We found a lower prevalence of EPEC (22.5%) in pilgrims who declared washing their hands more frequently at the Hajj than usually as compared to others (40.0%). CONCLUSION: The acquisition of diarrhea associated E coli by Hajj pilgrims is of major concern given the high prevalence rate of third-generation cephalosporin-resistant E. coli in Saudi Arabia.
Authors: Hamid Bokhary; Hajj Research Team; Osamah Barasheed; Hala B Othman; Burhanudin Saha; Harunor Rashid; Grant A Hill-Cawthorne; Moataz Abd El Ghany Journal: Access Microbiol Date: 2022-04-25
Authors: Thi Loi Dao; Van Thuan Hoang; Tran Duc Anh Ly; Amal Magmoun; Naomie Canard; Tassadit Drali; Florence Fenollar; Laetitia Ninove; Didier Raoult; Philippe Parola; Johan Courjon; Philippe Gautret Journal: Travel Med Infect Dis Date: 2019-12-21 Impact factor: 6.211
Authors: Sarah Aherfi; Philippe Gautret; Hervé Chaudet; Didier Raoult; Bernard La Scola Journal: Int J Infect Dis Date: 2020-08-21 Impact factor: 3.623
Authors: Saber Yezli; Abdulaziz Mushi; Yasir Almuzaini; Bander Balkhi; Yara Yassin; Anas Khan Journal: Int J Environ Res Public Health Date: 2021-01-28 Impact factor: 3.390