We conducted this study to describe the dynamics of the acquisition of respiratory pathogens, their potential interactions and risk factors for possible lower respiratory tract infection symptoms (LRTI) among French pilgrims during the 2018 Hajj. Each participant underwent four successive systematic nasopharyngeal swabs before and during their stay in Saudi Arabia. Carriage of the main respiratory pathogens was assessed by PCR. 121 pilgrims were included and 93.4% reported respiratory symptoms during the study period. The acquisition of rhinovirus, coronaviruses and Staphylococcus aureus occurred soon after arrival in Saudi Arabia and rates decreased gradually after days 5 and 6. In contrast, Streptococcus pneumoniae and Klebsiella pneumoniae carriage increased progressively until the end of the stay in Saudi Arabia. Haemophilus influenzae and Moraxella catarrhalis carriage increased starting around days 12 and 13, following an initial clearance. Influenza viruses were rarely isolated. We observed an independent positive mutual association between S. aureus and rhinovirus carriage and between H. influenzae and M. catarrhalis carriage. Dual carriage of H. influenzae and M. catarrhalis was strongly associated with S. pneumoniae carriage (OR = 6.22). Finally, our model showed that M. catarrhalis carriage was negatively associated with K. pneumoniae carriage. Chronic respiratory disease was associated with symptoms of LRTI. K. pneumoniae, M. catarrhalis-S. aureus and H. influenzae-rhinovirus dual carriage was associated with LRTI symptoms. Our data suggest that RTIs at the Hajj are a result of complex interactions between a number of respiratory viruses and bacteria.

中文翻译：

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2018年朝Ha期间法国朝圣者之间呼吸道病原体携带的动力学和相互作用。

我们进行了这项研究，以描述2018年朝圣期间呼吸道病原体获取的动力学，其潜在的相互作用以及法国朝圣者可能下呼吸道感染症状（LRTI）的危险因素。每个参与者在沙特阿拉伯逗留之前和逗留期间均接受了四次连续的鼻咽拭子治疗。通过PCR评估主要呼吸道病原体的运输。在研究期间，包括121名朝圣者，其中93.4％报告了呼吸道症状。到达沙特阿拉伯后不久就获得了鼻病毒，冠状病毒和金黄色葡萄球菌，并且在第5天和第6天后发病率逐渐下降。相比之下，肺炎链球菌和肺炎克雷伯菌的携带量逐渐增加，直到在沙特阿拉伯停留的时间结束。在最初清除后的第12天和第13天左右，流感嗜血杆菌和卡他莫拉菌的运输增加。很少感染流感病毒。我们观察到金黄色葡萄球菌和鼻病毒运输之间以及流感嗜血杆菌和卡他莫拉氏菌运输之间存在独立的正相互关联。流感嗜血杆菌和卡他莫拉菌的双重运输与肺炎链球菌的运输密切相关（OR = 6.22）。最后，我们的模型表明，卡他莫拉氏菌携带与肺炎克雷伯菌携带负相关。慢性呼吸系统疾病与LRTI症状有关。肺炎克雷伯氏菌，卡他莫拉氏菌-S。金黄色葡萄球菌和鼻-鼻炎病毒双重运输与LRTI症状有关。