Epidemiological surveillance of Shigella spp. in Australia is conducted to inform public health response. Multi-drug resistance has recently emerged as a contributing factor to sustained local transmission of Shigella spp. All data were collected as part of routine public health surveillance, and strains were whole-genome sequenced for further molecular characterisation. 108 patients with an endemic regional Shigella flexneri strain were identified between 2016 and 2019. The S. flexneri phylogroup 3 strain endemic to northern Australia acquired a multi-drug resistance conferring blaDHA plasmid, which has an IncFII plasmid backbone with virulence and resistance elements typically found in IncR plasmids. This is the first report of multi-drug resistance in Shigella sp. in Australia that is not associated with men who have sex with men. This strain caused an outbreak of multi-drug-resistant S. flexneri in northern Australia that disproportionality affects Aboriginal and Torres Strait Islander children. Community controlled public health action is recommended.

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RETRACTED ARTICLE: Gastrointestinal symptoms and the acquisition of enteric pathogens in Hajj pilgrims: a 3-year prospective cohort study

Hoang, Van-Thuan; Dao, Thi-Loi; Ly, Tran Duc Anh; Sow, Doudou; Belhouchat, Khadidja; Larbi Chaht, Kamel; Ninove, Laetitia; Drali, Tassadit; Yezli, Saber; Alotaibi, Badriah; Raoult, Didier; Parola, Philippe; de Santi, Vincent Pommier; Gautret, Philippe

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RETRACTED ARTICLE: A novel approach to managing COVID-19 patients; results of lopinavir plus doxycycline cohort

Cag, Yasemin; Icten, Sacit; Isik-Goren, Burcu; Baysal, Naciye Betul; Bektas, Begum; Selvi, Ece; Ergen, Pinar; Aydin, Ozlem; Ucisik, Ayse Canan; Yilmaz-Karadag, Fatma; Caskurlu, Hulya; Akarsu-Ayazoglu, Tulin; Kocoglu, Hasan; Uzman, Sinan; Nural-Pamukcu, Muge;

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2021 European Journal of Clinical Microbiology & Infectious Diseases

doi: 10.1007/s10096-020-04018-zpmid: 32918166

The acquisition of enteric pathogens and risk factors forHajj-associated diarrhea in Hajj pilgrims is poorly documented. Pilgrims fromMarseille participating in the Hajj in 2016–2018 underwent successive systematicrectal swabbing before and after their travel. Carriage of the main entericpathogens was assessed by real-time PCR. Baseline demographics, adherence toindividual preventive measures, gastrointestinal symptoms, and treatments wererecorded. A total of 376 pilgrims were included. The median age was 62.0 years.During the Hajj, 18.6% presented at least one gastrointestinal symptom, 13.8% haddiarrhea, and 36.4% had acquired at least one enteric pathogen. EnteropathogenicEscherichia coli (EPEC) and EnteroaggregativeE. coli (EAEC) were the pathogens mostfrequently acquired by pilgrims (17.6% and 14.4%, respectively). Being female wasassociated with increased frequency of gastrointestinal symptoms during thepilgrimage (aOR = 2.38, p = 0.004).Enterohemorrhagic Escherichia coli (EHEC)acquisition was associated with a four-fold higher risk of reporting at least onegastrointestinal symptom and diarrhea (aOR = 3.68 and p = 0.01 and aOR = 3.96 and p = 0.01, respectively). Pilgrims who suffered from diarrhea were morelikely to wash their hands more often (aOR = 2.07, p = 0.03) and to be either overweight (aOR = 2.71, p = 0.03) or obese (aOR = 2.51, p = 0.05). Enteric bacteria such as E.coli that are frequently associated with traveler’s diarrhea due tothe consumption of contaminated food and drink were frequently found in pilgrims.Respecting strict measures regarding food and water quality during the Hajj andadherence to preventive measures such as good personal hygiene and environmentalmanagement will help reduce the burden of gastrointestinal infections at theevent.

Arslan, Ferhat;

Bas, Gurhan;

Kalcioglu, Mahmut Tayyar;

Vahaboglu, Haluk

2021 European Journal of Clinical Microbiology & Infectious Diseases

doi: 10.1007/s10096-020-04016-1pmid: 32856202

This manuscript aims to present a treatment algorithm we applied to manage COVID-19 patients admitted to our hospital. During the study period, 2043 patients with suspected COVID-19 were admitted to the emergency department. Molecular tests indicated that 475 of these patients tested positive for COVID-19. We administered hydroxychloroquine plus doxycycline to mild cases (isolated at home) for 3 days and lopinavir plus doxycycline to moderate and severe cases (hospitalized) for 5 days. The overall case fatality rate was 4.2% (20/475).