Publications by authors named "Philippe Gautret"

270 Publications

Emergence and outcome of the SARS-CoV-2 "Marseille-4" variant.

Int J Infect Dis 2021 Mar 27. Epub 2021 Mar 27.

IHU Méditerranée Infection, Marseille, France; Aix-Marseille Univ, Microbes Evolution Phylogeny and Infections (MEPHI), Marseille, France. Electronic address:

Introduction: In Marseille, France, following a first SARS-CoV-2 outbreak in March-May 2020, a second epidemic phase occurred from June, involving ten new variants. The Marseille-4 variant caused an epidemic that started in August and is still ongoing.

Materials And Methods: The 1,038 SARS-CoV-2 whole genome sequences obtained in our laboratory by next-generation sequencing with Illumina technology were analyzed using Nextclade and nextstrain/ncov pipelines and IQ-TREE. A Marseille-4-specific qPCR assay was implemented. Demographic and clinical features were compared between patients with Marseille-4 and earlier strains.

Results: Marseille-4 harbors 13 hallmark mutations. One leads to S477 N substitution in the spike receptor binding domain targeted by current vaccines. Using a specific qPCR, we observed that Marseille-4 caused 12-100% of SARS-CoV-2 infections in Marseille from September 2020, being involved in 2,106 diagnoses. This variant was more frequently associated with hypoxemia than clade 20A strains before May 2020. It caused re-infection in eleven patients SARS-CoV-2-diagnosed with different strains before June 2020, suggesting either short-term protective immunity or lack of cross-immunity.

Discussion/conclusion: Marseille-4 should be considered as a major SARS-CoV-2 variant. Its sudden appearance points toward an animal reservoir, possibly minks. The protective role of past-exposure and current vaccines against this variant should be evaluated.
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http://dx.doi.org/10.1016/j.ijid.2021.03.068DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7997945PMC
March 2021

Combination of Hydroxychloroquine Plus Azithromycin As Potential Treatment for COVID-19 Patients: Safety Profile, Drug Interactions, and Management of Toxicity.

Microb Drug Resist 2021 Mar;27(3):281-290

Service de Pharmacie, Hôpital de la Timone, APHM, Marseille, France.

The coronavirus disease 2019 (COVID-19), caused by infection with severe acute respiratory syndrome coronavirus 2, has recently emerged worldwide. In this context, there is an urgent need to identify safe and effective therapeutic strategies for treatment of such highly contagious disease. We recently reported promising results of combining hydroxychloroquine and azithromycin as an early treatment option. Although ongoing clinical trials are challenging the efficacy of this combination, many clinicians claim the authorization to or have already begun to use it to treat COVID-19 patients worldwide. The aim of this article is to share pharmacology considerations contributing to the rationale of this combination, and to provide safety information to prevent toxicity and drug-drug interactions, based on available evidence.
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http://dx.doi.org/10.1089/mdr.2020.0232DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7987362PMC
March 2021

Hydroxychloroquine + azithromycin treatment in elderly patients.

Int J Antimicrob Agents 2021 Apr 11;57(4):106313. Epub 2021 Mar 11.

IHU-Méditerranée Infection, Marseille, France; Aix-Marseille Univ., IRD, APHM, MEPHI, Marseille, France.

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http://dx.doi.org/10.1016/j.ijantimicag.2021.106313DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7948678PMC
April 2021

Sputum proteomic analysis for distinguishing between pulmonary tuberculosis and non-tuberculosis using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS): preliminary results.

Clin Microbiol Infect 2021 Mar 9. Epub 2021 Mar 9.

Aix Marseille Université, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France. Electronic address:

Objectives: The aim was to evaluate the feasibility and diagnostic contribution of protein profiling using matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry (MS) applied to sputum to diagnose pulmonary tuberculosis.

Methods: Sputum samples collected from patients suspected of having pulmonary tuberculosis were analysed using MALDI-TOF MS. Using the differentially expressed protein peaks, we compared three groups of patients, including those with confirmed pulmonary tuberculosis (PTB), those without tuberculosis but with a lower respiratory tract infection (non-TB LRTI) and those without tuberculosis and without an LRTI (non-TB controls).

Results: A total of 102 patients included 35 PTB, 36 non-TB LRTI and 31 non-TB controls. The model differentiated between the PTB patients and the non-TB controls using the 25 most differentially expressed protein peaks, with a sensitivity of 97%, 95% CI 85-100%, and a specificity of 77%, 95% CI 59-90%. The model distinguished the PTB patients from the non-TB LRTI patients using the ten most differentially expressed protein peaks, with a sensitivity of 80%, 95% CI 63-92%, and a specificity of 89%, 95% CI 74-97%. We observed that the negative predictive value of MALDI-TOF MS sputum analysis was higher (96%, 95% CI 80-100%) than that of direct sputum microscopic examination and sputum culture (78%, 95% CI 62-89%) for non-TB controls. When MALDI-TOF MS sputum analysis and direct microscopic examination were combined, the negative predictive value reached 94%, 95% CI 80-99%, for non-TB LRTI patients.

Discussion: These results suggest that MALDI-TOF MS sputum analysis coupled with microscopic examination could be used as a screening tool for diagnosing pulmonary TB.
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http://dx.doi.org/10.1016/j.cmi.2021.02.031DOI Listing
March 2021

Variants, vaccines and vaccination passports: Challenges and chances for travel medicine in 2021.

Travel Med Infect Dis 2021 Mar-Apr;40:101996. Epub 2021 Feb 23.

School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.

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http://dx.doi.org/10.1016/j.tmaid.2021.101996DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899929PMC
February 2021

Multiple itchy lesions after recent travel.

BMJ 2021 02 24;372:n231. Epub 2021 Feb 24.

Faculty of Medicine, Aix Marseille Université, Marseille, France.

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http://dx.doi.org/10.1136/bmj.n231DOI Listing
February 2021

Screening Strategy of Active Pulmonary Tuberculosis in Sheltered Homeless People in Marseille, 2019.

J Epidemiol Glob Health 2021 Mar 15;11(1):124-131. Epub 2020 Oct 15.

Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.

We aimed to assess the reliability of a screening questionnaire for Active Pulmonary Tuberculosis (APTB) in a population of sheltered homeless persons (HP). Participants from two homeless shelters completed a questionnaire specially designed to identify patients at high-risk of APTB (available at www.tb-screen.ch), underwent a Chest X-ray (CXR), and provided sputum samples. Computed Tomography (CT) scanning was subsequently performed on those which had images consistent with APTB. Microscopical examination, real-time polymerase chain reaction (qPCR) and culture testing were applied for complex detection. Additionally, we retrospectively selected 16 HP hospitalised in our hospital between 2017 and 2019 with biologically confirmed tuberculosis and typical CXR images, and retrospectively documented a screening questionnaire by reviewing their medical files. Overall, the population ( = 383 HP) was predominantly migrants (87%). Forty-seven individuals (11.7%) had positive screening questionnaire scores and four (2.4%) displayed abnormal CXR features consistent with APTB. Three of them three underwent CT scanning that ruled out APTB and one was lost to follow-up. None tested positive through microbiological investigation. Fifteen (of 16, 93.8%) hospitalised patients with biologically confirmed APTB had a positive screening questionnaire score. The sensitivity and specificity of questionnaire for confirmed APTB were 93.8% and 87.7%, respectively. Screening questionnaires can be used as a first assessment tool in people arriving at homeless shelters and to refer those screening positive for a CXR.
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http://dx.doi.org/10.2991/jegh.k.201009.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7958279PMC
March 2021

Effect of hydroxychloroquine and azithromycin on the viral clearance of SARS-CoV-2: response to Hervé Seligmann.

Int J Antimicrob Agents 2021 Mar 14;57(3):106306. Epub 2021 Feb 14.

IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France.

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http://dx.doi.org/10.1016/j.ijantimicag.2021.106306DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7946400PMC
March 2021

Variations in respiratory pathogen carriage among a homeless population in a shelter for men in Marseille, France, March-July 2020: cross-sectional 1-day surveys.

Eur J Clin Microbiol Infect Dis 2021 Feb 13. Epub 2021 Feb 13.

IRD, AP-HM, SSA, VITROME, Aix Marseille Univ, Marseille, France.

We aimed to compare respiratory pathogen carriage by PCR during three different time periods in 2020 in sheltered homeless people in Marseille, France. The overall prevalence of respiratory pathogen carriage in late March-early April (69.9%) was significantly higher than in late April (42.3%) and mid-July (45.1%). Bacterial carriage significantly decreased between late March-early April and late April. SARS-CoV-2 was detected only in late March-early April samples (20.6%). Measures aiming at mitigating SARS-CoV-2 transmission were effective and also impacted bacterial carriage. Seasonal variations of bacterial carriage between winter and summer in this population were not marked.
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http://dx.doi.org/10.1007/s10096-020-04127-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7881748PMC
February 2021

Screening of SARS-CoV-2 among homeless people, asylum-seekers and other people living in precarious conditions in Marseille, France, March-April 2020.

Int J Infect Dis 2021 Feb 10;105:1-6. Epub 2021 Feb 10.

Aix-Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France. Electronic address:

Background: Surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among sheltered homeless and other vulnerable people might provide the information needed to prevent its spread within accommodation centres.

Methods: Data were obtained from 698 participants in different accommodation centres (411 homeless individuals, 77 asylum-seekers, 58 other people living in precarious conditions and 152 employees working in these accommodation centres) who completed questionnaires and had nasal samples collected between 26 March and 17 April 2020. SARS-CoV-2 carriage was assessed by quantitative PCR.

Results: We found a high acceptance rate (78.9%) for testing. Overall, 49 people (7.0%) were positive for SARS-CoV-2, including 37 homeless individuals (of 411, 9.0%) and 12 employees (of 152, 7.9%). SARS-CoV-2 positivity correlated with symptoms, although 51% of patients who tested positive did not report respiratory symptoms or fever. Among homeless people, being young (18-34 years) (odds ratio 3.83, 95% confidence interval 1.47-10.0, p = 0.006) and being housed in one specific shelter (odds ratio 9.13, 95% confidence interval 4.09-20.37, p < 0.001) were independent factors associated with SARS-CoV-2 positivity (rates of 11.4% and 20.6%, respectively).

Discussion: Symptom screening alone is insufficient to prevent SARS-CoV-2 transmission in vulnerable sheltered people. Systematic testing should be promoted.
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http://dx.doi.org/10.1016/j.ijid.2021.02.026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7872841PMC
February 2021

Comparative genomics of two Shewanella xiamenensis strains isolated from a pilgrim before and during travels to the Hajj.

Gut Pathog 2021 Feb 9;13(1). Epub 2021 Feb 9.

Aix Marseille Univ, IRD, APHM, MEPHI, IHU Méditerranée Infection, Faculté de Médecine Et de Pharmacie, 19-21 Boulevard Jean Moulin, 13385, Marseille CEDEX 05, France.

Background: Shewanella xiamenensis has been reported in water environment and in patients and can act as the originator of oxacillinase in gram-negative bacteria. In order to assess genome plasticity and its functional properties related diarrhea symptoms in pilgrim, comparisons of draft genome sequences of the two isolates were conducted with other closely related genomes.

Results: We isolated S. xiamenensis 111B and 111D strains from a pilgrim before travels to the Hajj and during travels with diarrhea symptom, respectively. Whole-genome sequencing showed that draft genome size of 111B strain was 5,008,191 bp, containing 49 kb of a putative plasmid. The genome size of 111D was 4,964,295 bp containing 225 kb of a putative plasmid that shared the backbone sequences with the hospital wastewater strain T17. Comparatively, two Hajj strains are identical at 97.3% identity and 98.7% coverage. They are closely related to river water strain, AS58 by SNPs analysis. Notably, a novel bla allele bla was identified in 111D, sharing 99.5% identity with bla and bla. Multiple copies of virulence specific genes, such as capsular polysaccharide biosynthesis, O-antigen and lasB (vibriolysin related gene) have been identified specifically in 111D, but absent in 111B strain.

Conclusions: The whole genome sequences of S. xiamenensis strain 111B and 111D, including comparative genomic analysis, highlight here the potential for virulence factors that might be related to the cause of diarrhea in humans and also indicate the possible acquisition of pathogenic bacteria, including antibiotic resistance genes or plasmids during the Hajj.
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http://dx.doi.org/10.1186/s13099-021-00404-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7871542PMC
February 2021

Reply to Alizazgar J. Dangers of the use of hydroxychloroquine and azithromycin combination in COVID-19 patients.

Travel Med Infect Dis 2021 Mar-Apr;40:101984. Epub 2021 Feb 5.

IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, SSA, VITROME, Marseille, France. Electronic address:

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http://dx.doi.org/10.1016/j.tmaid.2021.101984DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7862014PMC
April 2021

Introduction into the Marseille geographical area of a mild SARS-CoV-2 variant originating from sub-Saharan Africa: An investigational study.

Travel Med Infect Dis 2021 Mar-Apr;40:101980. Epub 2021 Jan 31.

IHU Méditerranée Infection, Marseille, France; Aix-Marseille Univ, Microbes Evolution Phylogeny and Infections (MEPHI), Marseille, France. Electronic address:

Background: In Marseille, France, the COVID-19 incidence evolved unusually with several successive epidemic phases. The second outbreak started in July, was associated with North Africa, and involved travelers and an outbreak on passenger ships. This suggested the involvement of a new viral variant.

Methods: We sequenced the genomes from 916 SARS-CoV-2 strains from COVID-19 patients in our institute. The patients' demographic and clinical features were compared according to the infecting viral variant.

Results: From June 26th to August 14th, we identified a new viral variant (Marseille-1). Based on genome sequences (n = 89) or specific qPCR (n = 53), 142 patients infected with this variant were detected. It is characterized by a combination of 10 mutations located in the nsp2, nsp3, nsp12, S, ORF3a, ORF8 and N/ORF14 genes. We identified Senegal and Gambia, where the virus had been transferred from China and Europe in February-April as the sources of the Marseille-1 variant, which then most likely reached Marseille through Maghreb when French borders reopened. In France, this variant apparently remained almost limited to Marseille. In addition, it was significantly associated with a milder disease compared to clade 20A ancestor strains, in univariate analysis.

Conclusion: Our results demonstrate that SARS-CoV-2 can genetically diversify rapidly, its variants can diffuse internationally and cause successive outbreaks.
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http://dx.doi.org/10.1016/j.tmaid.2021.101980DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847701PMC
January 2021

Molecular Characterization and Genetic Diversity of Haplogroup E Human Lice in Guinea, West Africa.

Microorganisms 2021 Jan 27;9(2). Epub 2021 Jan 27.

Aix Marseille University, IRD, APHM, MEPHI, IHU-Méditerranée Infection, 13005 Marseille, France.

, the head louse, is an obligate blood-sucking ectoparasite that occurs in six divergent mitochondrial clades (A, D, B, F, C and E). Several studies reported the presence of different pathogenic agents in head lice specimens collected worldwide. These findings suggest that head louse could be a dangerous vector and a serious public health problem. Herein, we aimed to study the mitochondrial genetic diversity, the PHUM540560 gene polymorphisms profile of head lice collected in Guinea, as well as to screen for their associated pathogens. In 2018, a total of 155 head lice were collected from 49 individuals at the Medicals Centers of rural (Maférinyah village) and urban (Kindia city) areas, in Guinea. Specimens were subjected to a genetic analysis and pathogens screening using molecular tools. Results showed that all head lice belonged to eight haplotypes in the E haplogroup, with six newly identified for the first time. The study of the PHUM540560 gene polymorphisms of our clade E-head lice revealed that 82.5% exhibited the same polymorphism profile as the previously reported clade A-body lice. Screening for targeted pathogens revealed the presence of spp., while sequencing highlighted the presence of several species, including , and for the first time . Our study is the first to report the existence of the Guinean haplogroup E, the PHUM540560 gene polymorphism profile as well as the presence of species in head lice collected from Guinea.
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http://dx.doi.org/10.3390/microorganisms9020257DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7911403PMC
January 2021

Enteric pathogenic bacteria and resistance gene carriage in the homeless population in Marseille, France.

Acta Microbiol Immunol Hung 2021 Jan 27. Epub 2021 Jan 27.

1Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France.

We aimed to assess the prevalence of pathogenic bacteria and resistance genes in rectal samples collected among homeless persons in Marseille, France. In February 2014 we enrolled 114 sheltered homeless adults who completed questionnaires and had rectal samples collected. Eight types of enteric bacteria and 15 antibiotic resistance genes (ARGs) were sought by real-time polymerase chain reaction (qPCR) performed directly on rectal samples. ARG-positive samples were further tested by conventional PCR and sequencing. We evidenced a 17.5% prevalence of gastrointestinal symptoms, a 9.6% prevalence of enteric pathogenic bacteria carriage, including Escherichia coli pathotypes (8.7%) and Tropheryma whipplei (0.9%). Only 2 persons carried blaCTX-M-15 resistance genes (1.8%), while other genes, including carbapenemase-encoding genes and colistin-resistance genes, (mcr-1 to mcr-6, mcr-8) were not detected. Our results suggest that sheltered homeless persons in Marseille do not have a high risk of harbouring gastrointestinal antibiotic resistant bacteria.
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http://dx.doi.org/10.1556/030.2021.01346DOI Listing
January 2021

Vaccine-preventable diseases other than tuberculosis, and homelessness: A scoping review of the published literature, 1980 to 2020.

Vaccine 2021 Feb 26;39(8):1205-1224. Epub 2021 Jan 26.

Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France. Electronic address:

Background: Homelessness may result in the breakdown of regular health services, including routine vaccination programmes. A scoping review was conducted to describe vaccine-preventable diseases (VPD) other than tuberculosis in people experiencing homelessness (PEH).

Methods: We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We searched peer-reviewed literature published in English, French, Spanish or Portuguese reporting the outbreak of VPD or VPD prevalence in both infant and adult homeless populations published between 1980 and 2020, using PubMed/Medline, SciELO, Google Scholar, and Web of Science databases. Relevant information from the studies was charted in Microsoft Excel and results were summarised using a descriptive analytical method.

Results: Eighty-one articles were included. A high prevalence of past hepatitis B virus (HBV) and hepatitis A virus (HAV) infections were observed through serosurveys, mostly in high income countries or high-middle income countries (USA, Canada, France, Iran or Brazil). Ten outbreaks of HAV infection were also reported, with lethality rates ranging from 0 to 4.8%. The studies identified numerous risk factors positively associated with HBV infection, including older age, homosexual or bisexual practice, injected drug use (IDU), and, with HAV infection including IDU, having sexual partner(s) with a history of unspecified hepatitis, insertive anal penetration, or originating from a country with a high prevalence of anti-HAV antibody. Eleven outbreaks of pneumococcal infection affecting PEH were reported in Canada and USA, with lethality rates from 0 to 15.6%. Six diphtheria outbreaks were reported. Vaccination status was rarely documented in these studies.

Conclusions: The literature suggests that homeless populations generally experience a high VPD burden suggesting the need for a national vaccination programme and planning for delivering vaccines in this population.
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http://dx.doi.org/10.1016/j.vaccine.2021.01.035DOI Listing
February 2021

The Grand Magal of Touba was spared by the COVID-19 pandemic.

Int J Infect Dis 2021 Jan 9;105:470-471. Epub 2021 Jan 9.

IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.

In the context of the coronavirus disease-2019 (COVID-19) pandemic, all mass gathering (MG) events have been cancelled. The Grand Magal took place on October 6, 2020, in Touba, Senegal, which was the only MG event organized in 2020. This Muslim pilgrimage gathers about four million Muslim Mourides from Senegal and beyond. No significant increase in COVID-19 cases was therefore observed at the national level in the weeks following the Grand Magal. This successful strategy is an invitation to better promote community commitments by public authorities in their various strategies.
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http://dx.doi.org/10.1016/j.ijid.2021.01.006DOI Listing
January 2021

Long-term persistence of olfactory and gustatory disorders in COVID-19 patients.

Clin Microbiol Infect 2021 Jan 5. Epub 2021 Jan 5.

Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France. Electronic address:

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http://dx.doi.org/10.1016/j.cmi.2020.12.021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7784539PMC
January 2021

Acquisition of multidrug-resistant bacteria and encoding genes among French pilgrims during the 2017 and 2018 Hajj.

Eur J Clin Microbiol Infect Dis 2021 Jan 7. Epub 2021 Jan 7.

IRD, AP-HM, SSA, VITROME, Aix Marseille University, Marseille, France.

The objective of this study is to determine the acquisition of multidrug-resistant (MDR) bacteria and antibiotic resistance-encoding genes by French Hajj pilgrims and associated risk factors. Pilgrims traveling during the 2017 and 2018 Hajj were recruited. All pilgrims underwent two successive systematic nasopharyngeal and rectal swabs, pre- and post-Hajj. Specific culture media were used to screen for MDR bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant bacteria, and extended spectrum beta-lactamase producing Enterobacteriaceae (ESBL-E). qPCR was used to identify antibiotic resistance-encoding genes from cultured isolates. Direct screening of genes encoding for colistin resistance (mcr-1, 2, 3, 4, 5, and 8) from nasopharyngeal and rectal swabs was performed using qPCR, and positive qPCR results were simultaneously tested by sequencing. There were 268 pilgrims included. The percentage of pilgrims acquiring MDR bacteria during the Hajj was 19.4%. A total of 81 strains were isolated (1 carbapenem-resistant Acinetobacter baumannii, 12 MRSA, and 68 ESBL-E). ESBL-E strains were found in rectal samples of 6.0% pilgrims pre-Hajj and of 16.4% pilgrims post-Hajj. Only 0.4% pilgrims were positive for CARB post-Hajj and 1.9% carried nasal MRSA pre- and post-Hajj. In addition, 23 (8.6%) post-Hajj rectal swabs were positive for mcr genes (19 mcr-1 gene and 4 mcr-4 gene). No significant association was found between co-factors and acquisition of MDR bacteria or mcr genes. MDR bacteria and genes are acquired by pilgrims during the Hajj mass gathering. Rationalization of antibiotic consumption and implementation of measures to prevent transmission of bacteria among pilgrims during the event are of paramount importance.
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http://dx.doi.org/10.1007/s10096-020-04122-0DOI Listing
January 2021

Clinical efficacy and safety profile of hydroxychloroquine and azithromycin against COVID-19.

Int J Antimicrob Agents 2021 Jan;57(1):106242

IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France. Electronic address:

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http://dx.doi.org/10.1016/j.ijantimicag.2020.106242DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779282PMC
January 2021

Interpretation of SARS-CoV-2 PCR results for the diagnosis of COVID-19.

Int J Antimicrob Agents 2021 Jan;57(1):106238

IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France. Electronic address:

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http://dx.doi.org/10.1016/j.ijantimicag.2020.106238DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779259PMC
January 2021

Response to advances statistical methods and designs for clinical trials for COVID-19.

Int J Antimicrob Agents 2021 01;57(1):106235

IHU-Méditerranée Infection, Marseille, France.; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France. Electronic address:

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http://dx.doi.org/10.1016/j.ijantimicag.2020.106235DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779263PMC
January 2021

Response to effect estimation of hydroxychloroquine for COVID-19: a secondary analysis of an open label non-randomized clinical trial.

Int J Antimicrob Agents 2021 01;57(1):106237

IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France. Electronic address:

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http://dx.doi.org/10.1016/j.ijantimicag.2020.106237DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779261PMC
January 2021

Safety profile of hydroxychloroquine and azithromycin combined treatment in COVID-19 patients.

Int J Antimicrob Agents 2021 Jan;57(1):106236

IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France. Electronic address:

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http://dx.doi.org/10.1016/j.ijantimicag.2020.106236DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779283PMC
January 2021

Effect of hydroxychloroquine and azithromycin on SARS-CoV-2 clearance in COVID-19 patients, a meta-analysis.

Int J Antimicrob Agents 2021 Jan;57(1):106240

IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France. Electronic address:

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http://dx.doi.org/10.1016/j.ijantimicag.2020.106240DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779266PMC
January 2021

Response to uncertain effect of hydroxychloroquine and azithromycin on SARS-CoV-2 viral load.

Int J Antimicrob Agents 2021 01;57(1):106244

IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France. Electronic address:

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http://dx.doi.org/10.1016/j.ijantimicag.2020.106244DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7832548PMC
January 2021

Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open label non-randomized clinical trial revisited.

Int J Antimicrob Agents 2021 Jan;57(1):106243

IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France. Electronic address:

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http://dx.doi.org/10.1016/j.ijantimicag.2020.106243DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779265PMC
January 2021

Natural history of COVID-19 and therapeutic options.

Expert Rev Clin Immunol 2020 12 24;16(12):1159-1184. Epub 2020 Dec 24.

Institut Hospitalo-Universitaire Méditerranée Infection , Marseille, France.

: COVID-19 presents benign forms in young patients who frequently present with anosmia. Infants are rarely infected, while severe forms occur in patients over 65 years of age with comorbidities, including hypertension and diabetes. Lymphopenia, eosinopenia, thrombopenia, increased lactate dehydrogenase, troponin, C-reactive protein, D-dimers and low zinc levels are associated with severity.: The authors review the literature and provide an overview of the current state of knowledge regarding the natural history of and therapeutic options for COVID-19. : Diagnosis should rely on PCR and not on clinical presumption. Because of discrepancies between clinical symptoms, oxygen saturation or radiological signs on CT scans, pulse oximetry, and radiological investigation should be systematic. The disease evolves in successive phases: an acute virological phase, and, in some patients, a cytokine storm phase; an uncontrolled coagulopathy; and an acute respiratory distress syndrome. Therapeutic options include antivirals, oxygen therapy, immunomodulators, anticoagulants and prolonged mechanical treatment. Early diagnosis, care, and implementation of an antiviral treatment; the use of immunomodulators at a later stage; and the quality of intensive care are critical regarding mortality rates. The higher mortality observed in Western countries remains unexplained. Pulmonary fibrosis may occur in some patients. Its future is unpredictable.
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http://dx.doi.org/10.1080/1744666X.2021.1847640DOI Listing
December 2020