Antimicrobial resistance acquisition after international travel in U.S. travelers

被引：14

作者：

Blyth D.M. ^{[1
]}

Mende K. ^{[1
,2
,3
]}

Maranich A.M. ^{[4
]}

Beckius M.L. ^{[1
]}

Harnisch K.A. ^{[1
]}

Rosemann C.A. ^{[1
]}

Zera W.C. ^{[1
,2
,3
]}

Murray C.K. ^{[1
]}

Akers K.S. ^{[1
,5
]}

机构：

[1] Infectious Disease Service, San Antonio Military Medical Center, JBSA Fort Sam Houston, 3551 Roger Brooke Drive, Houston, 78234-4505, TX

[2] Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD

[3] The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD

[4] Pediatric Infectious Disease Service, San Antonio Military Medical Center, JBSA Fort Sam Houston, Houston, TX

[5] U.S. Army Institute for Surgical Research, JBSA Fort Sam Houston, Houston, TX

来源：

Tropical Diseases, Travel Medicine and Vaccines | / 2卷 / 1期

关键词：

ESBL-producing Enterobacteriaceae; Eschericia coli; Methicillin-resistant Staphylococcus aureus (MRSA); Travel;

D O I：

10.1186/s40794-016-0020-2

中图分类号：

学科分类号：

摘要：

Background: Prior studies have shown an increase in multidrug-resistant (MDR) E. coli colonization from two percent in U.S.-based to 11 % in deployed, healthy military personnel. It is unclear if colonization with MDR organisms occurs through deployment exposures or risks related to routine overseas travel. This study prospectively evaluates rates and risk factors associated with MDR gram-negative bacterial and methicillin-resistant S. aureus (MRSA) colonization after international travel. Methods: Participants traveled internationally for five or more days. Pre- and post-travel, colonizing bacteria from oropharyngeal, nares, groin, and peri-rectal (PR) areas were collected using BD CultureSwab™ MaxV(+). Identification and susceptibilities were done utilizing the BD Phoenix™ Automated Microbiology System. Non-MDR pre- and posttravel MDR bacteria within a subject were compared by pulsed-field gel electrophoresis (PFGE). A questionnaire solicited demographics and potential risk factors for MDR acquisition. Results: Of 58 participants, 41 % were male and median age was 64 years. Pre- and post-travel swabs were obtained a median of ten and seven days before and after travel, respectively. Itineraries included 18 participants traveling to the Caribbean and Central America, 17 to Asia, 16 to Africa, 5 to Europe, 4 to South and North America. Seventeen of 22 travelers used atovaquone/proguanil for malaria prophylaxis. The only MDR organism isolated was extended-spectrum ß-lactamase (ESBL)-producing E. coli in five (9 %) participants post-travel (all PR and unrelated by PFGE). There were no statistically significant associations between exposure risks and new ESBL-producing E.coli colonization. Of 36 participants colonized with E. coli pre- and post-travel, new resistance was detected: TMP/SMX in 42 % of isolates (p < 0.01), tetracycline in 44 % (p < 0.01), and ampicillin-sulbactam in 33 % (p = 0.09). No participants were colonized with MRSA pre- or post-travel. Conclusion: Consistent with prior studies, new antimicrobial resistance was noted in colonizing E. coli after international travel. Nine percent of participants acquired new strains of ESBL-producing E.coli without identified risks. © 2016 Blyth et al.

引用

共 34 条

[1] Tangden T., Cars O., Melhus A., Lowdin E., Foreign travel is a major risk factor for colonization with Escherichia coli producing CTX-M-type extendedspectrum beta-lactamases: a prospective study with Swedish volunteers, Antimicrob Agents Chemother., 54, pp. 3564-3568, (2010)
[2] Weisenberg S.A., Mediavilla J.R., Chen L., Alexander E.L., Rhee K.Y., Kreiswirth B.N., Jenkins S.G., Extended spectrum beta-lactamase-producing Enterobacteriaceae in international travelers and non-travelers in New York City, PLoS One., 7, (2012)
[3] Peirano G., Laupland K.B., Gregson D.B., Pitout J.D., Colonization of returning travelers with CTX-M-producing Escherichia coli, J Travel Med., 18, pp. 299-303, (2011)
[4] Laupland K.B., Church D.L., Vidakovich J., Mucenski M., Pitout J.D., Communityonset extended-spectrum beta-lactamase (ESBL) producing Escherichia coli: importance of international travel, J Infect., 57, pp. 441-448, (2008)
[5] Freeman J.T., McBride S.J., Heffernan H., Bathgate T., Pope C., Ellis-Pegler R.B., Community-onset genitourinary tract infection due to CTX-M-15-Producing Escherichia coli among travelers to the Indian subcontinent in New Zealand, Clin Infect Dis., 47, pp. 689-692, (2008)
[6] van der Bij A.K., Pitout J.D., The role of international travel in the worldwide spread of multiresistant Enterobacteriaceae, J Antimicrob Chemother., 67, pp. 2090-2100, (2012)
[7] Ruppe E., Armand-Lefevre L., Estellat C., Consigny P.H., El Mniai A., Boussadia Y., Goujon C., Ralaimazava P., Campa P., Girard P.M., Et al., High rate of acquisition but short duration of carriage of multidrug-resistant Enterobacteriaceae after travel to the tropics, Clin Infect Dis., 61, (2015)
[8] Epelboin L., Robert J., Tsyrina-Kouyoumdjian E., Laouira S., Meyssonnier V., Caumes E., Et al., High rate of multidrug-resistant gramnegative bacilli carriage and infection in hospitalized returning travelers: a cross-sectional cohort study, J Travel Med., 22, (2015)
[9] Kantele A., Laaveri T., Mero S., Vilkman K., Pakkanen S.H., Ollgren J., Antikainen J., Kirveskari J., Antimicrobials increase travelers' risk of colonization by extendedspectrum betalactamase-producing Enterobacteriaceae, Clin Infect Dis., 60, pp. 837-846, (2015)
[10] Vento T.J., Cole D.W., Mende K., Calvano T.P., Rini E.A., Tully C.C., Zera W.C., Guymon C.H., Yu X., Cheatle K.A., Et al., Multidrug-resistant gram-negative bacteria colonization of healthy US military personnel in the US and Afghanistan, BMC Infect Dis., 13, (2013)

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