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.

本研究的目的是确定法国朝觐者获得的耐多药 (MDR) 细菌和抗生素抗性编码基因以及相关的危险因素。招募了在 2017 年和 2018 年朝觐期间旅行的朝圣者。在朝觐之前和之后，所有朝圣者都接受了两次连续的系统鼻咽和直肠拭子检查。使用特定培养基筛选耐多药细菌，包括耐甲氧西林金黄色葡萄球菌(MRSA)、耐碳青霉烯菌和产超广谱 β-内酰胺酶的肠杆菌科(ESBL-E)。qPCR 用于从培养的分离株中鉴定抗生素抗性编码基因。直接筛选编码粘菌素抗性 ( mcr)的基因-1、2、3、4、5 和 8) 来自鼻咽和直肠拭子使用 qPCR 进行，并且阳性 qPCR 结果同时通过测序进行测试。包括朝圣者268人。在朝觐期间获得 MDR 细菌的朝圣者的百分比为 19.4%。共分离出 81 株菌株（1 株耐碳青霉烯鲍曼不动杆菌、12株MRSA 和 68株ESBL-E）。在 6.0% 的朝觐前朝圣者和 16.4% 朝觐后朝圣者的直肠样本中发现了 ESBL-E 菌株。只有 0.4% 的朝圣者在朝觐后对 CARB 呈阳性，1.9% 在朝觐前后携带鼻 MRSA。此外，23 个 (8.6%) 朝觐后直肠拭子对mcr基因（19 个mcr-1基因和 4 个mcr-4基因）。未发现辅助因子与 MDR 细菌或mcr基因的获得之间存在显着关联。MDR 细菌和基因是在朝觐群众集会期间由朝圣者获得的。在活动期间，合理使用抗生素并采取措施防止细菌在朝圣者之间传播至关重要。