Acquisition of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) carriage after exposure to systemic antimicrobials during travel: Systematic review and meta-analysis

Wuerz, Terence; Kassim, Sameer S.; Atkins, Katherine E.

doi:10.1016/j.tmaid.2020.101823

Cited by 17 publications

(9 citation statements)

References 34 publications

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“…This in contrast to the study by Wuerz et al . that described that the risk of acquiring ESBL-producing Enterobacterales increases substantially when using antibiotics during travel [ 9 ]. Overall, more than 50% of patients used antibiotics in the year before admission.…”

Section: Discussionmentioning

confidence: 99%

Pre-COVID-19 international travel and admission to hospital when back home: travel behavior, carriage of highly resistant microorganisms, and risk perception of patients admitted to a large tertiary care hospital

holt

Schoor

Mourik

et al. 2022

Antimicrob Resist Infect Control

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Background When people who recently travelled abroad are admitted to a hospital back home, there is a risk of introducing highly resistant microorganisms (HRMO) into the hospital. To minimize this risk, a feasible infection prevention strategy should be developed. In this study, we investigated patients’ travel history and behavior during travel and analyzed whether this was correlated to HRMO carriage at admission. Methods From May 2018 until August 2019, adult patients admitted to a large tertiary care center in the Netherlands were asked upon hospital admission to participate in the study. Included patients received a questionnaire about risk perception, travel history in the last year, and behavior during travel, and were screened for HRMO carriage at admission using a perianal swab. Results Six hundred and eight questionnaires were handed out, of which 247 were returned (40.6%). One hundred and thirty (52.6%) patients did not travel abroad in the last year, of whom eight (6.2%) were HRMO carrier at admission. One hundred seventeen (47.4%) patients travelled in the preceding year, of whom seven patients (6.0%) were HRMO carrier at admission. Thirty patients (12%) travelled outside of Europe; in this group HRMO prevalence was 13.3% (4 out of 30). The majority of patients (71.3%) were aware that international travel could lead to carriage of HRMO, and an even larger majority (89.5%) would support a screening strategy upon hospital admission in case of a travel history, to minimize the risk of introducing HRMO. Conclusions We identified that half of admitted patients to a large tertiary care hospital travelled abroad in the last year, with only a small percentage outside Europe. We discuss several screening strategies and propose a strategy of screening and preemptive isolation of patients who travelled to Asia or Africa in the 2 months before their hospital admission; a strategy that patients would support.

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Section: Discussionmentioning

confidence: 99%

Pre-COVID-19 international travel and admission to hospital when back home: travel behavior, carriage of highly resistant microorganisms, and risk perception of patients admitted to a large tertiary care hospital

holt

Schoor

Mourik

et al. 2022

Antimicrob Resist Infect Control

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“…Thomas et al note that the frequency of AMR carriage appears roughly similar between short-term international travelers and migrants seeking resettlement. [37][38][39] However, in the US and Europe, the population of immigrants and forcibly displaced persons is overshadowed by the much larger population of short-term international travelers, and this difference has been growing over the past five decades. Therefore, effective interventions to reduce the spread of AMR will likely need to be implemented at the interface of international air travel.…”

Section: Dovepressmentioning

confidence: 99%

Antimicrobial Resistance and Human Mobility

Desai¹,

Mohareb²,

Hauser³

et al. 2022

IDR

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Antimicrobial resistance (AMR) is of increasing global concern. Human mobility is one factor that has recently been associated with AMR, though the extent of its impact has not yet been well established due to the limited availability of rigorous data. This review examines the existing literature regarding various types of human mobility including shortterm travelers, forcibly displaced persons, migrant populations, and their association with global rates of AMR.

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“…Travellers returning from endemic areas are at a high risk of being colonized or infected with ESBL-PE [13][14][15][16][17]. Travel returner cohorts allow us to study factors linked to colonization, duration of colonization, and the resulting impact on the gut microbiome.…”

Section: Introductionmentioning

confidence: 99%

ESBL Displace: A Protocol for an Observational Study to Identify Displacing Escherichia coli Strain Candidates from ESBL-Colonized Travel Returners Using Phenotypic, Genomic Sequencing and Metagenome Analysis

Schweitzer

Mari

Roloff

et al. 2023

Microbiology Research

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Introduction: Invading extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-PE), non-ESBL E. coli, and other bacteria form a complex environment in the gut. The duration and dynamics of ESBL-PE colonization varies among individuals. Understanding the factors associated with colonization may lead to decolonization strategies. In this study, we aim to identify (i) single E. coli strains and (ii) microbiome networks that correlate with retention or decline of colonization, and (iii) pan-sensitive E. coli strains that potentially could be used to displace ESBL-PE during colonization. Methods and analysis: We recruit healthy travellers to Southeast Asia for a one-year prospective observational follow-up study. We collect and biobank stool, serum, and peripheral blood mononuclear cells (PBMCs) at predefined timepoints. Additional information is collected with questionnaires. We determine the colonization status with ESBL-PE and non-ESBL E. coli and quantify cell densities in stools and ratios over time. We characterize multiple single bacterial isolates per patient and timepoint using whole genome sequencing (WGS) and 16S/ITS amplicon-based and shotgun metagenomics. We determine phylogenetic relationships between isolates, antimicrobial resistance (AMR; phenotypic and genotypic), and virulence genes. We describe the bacterial and fungal stool microbiome alpha and beta diversity on 16S/ITS metagenomic data. We describe patterns in microbiome dynamics to identify features associated with protection or risk of ESBL-PE colonization. Ethics and dissemination: The study is registered (clinicaltrials.gov; NCT04764500 on 09/02/2019) and approved by the Ethics Committee (EKNZ project ID 2019-00044). We will present anonymized results at conferences and in scientific journals. Bacterial sequencing data will be shared via publicly accessible databases according to FAIR principles.

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Acquisition of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) carriage after exposure to systemic antimicrobials during travel: Systematic review and meta-analysis

Abstract: doi: medRxiv preprint NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice..

Cited by 17 publications

References 34 publications

Pre-COVID-19 international travel and admission to hospital when back home: travel behavior, carriage of highly resistant microorganisms, and risk perception of patients admitted to a large tertiary care hospital

Pre-COVID-19 international travel and admission to hospital when back home: travel behavior, carriage of highly resistant microorganisms, and risk perception of patients admitted to a large tertiary care hospital

Antimicrobial Resistance and Human Mobility

ESBL Displace: A Protocol for an Observational Study to Identify Displacing Escherichia coli Strain Candidates from ESBL-Colonized Travel Returners Using Phenotypic, Genomic Sequencing and Metagenome Analysis

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