Extensively-drug-resistant bacteria carriers among overseas travellers: one-third had not been hospitalized previously

Macaux, Lou; Ndoye, Oulimata; Cordel, Hugues; Pomares, Typhaine Billard; Seytre, Delphine; Bouchaud, Olivier; Cohen, Yves; Zahar, Jean‐Ralph; Carbonnelle, Étienne

doi:10.1016/j.ijantimicag.2018.06.006

Cited by 10 publications

(13 citation statements)

References 27 publications

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“…51,52 In recent years, dissemination of emerging pathogens such as NDM-1 carbapenem-resistant K. pneumoniae from India 53 and mcr-1 colistin-resistant E. coli from China 54 were facilitated by international travel. 55,56 Of concern is F o r P e e r R e v i e w 12 that our review revealed that carbapenem- 28,37,44,45 and colistin 48 -resistant Enterobacterales are being detected in international travellers. Investment in infrastructure to provide access to clean water, and adequate sanitation and hygiene may reduce transmission in low-and middleincome countries, 4 and possibly reduce the global spread of AMR.…”

Section: Discussionmentioning

confidence: 99%

“…All the studies were conducted in Europe (The Netherlands, 12,13,35,37,38 Sweden, [39][40][41][42] Switzerland, 43,44 France, 28,45 Germany, 38,46 Finland, 30 United Kingdom, 10 and Denmark 47 ) except for three that were conducted in Australia, 33 Japan, 48,49 and the USA. 49 The median age of the participants ranged from 25 to 66 years.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…The median duration of travel ranged from 7 to 45 days, with 75% of the studies having a median duration of travel between 14 and 21 days. Thirteen studies collected stool samples, 10,13,28,30,35,[38][39][40]42,43,46,48,49 five studies used rectal swabs, 12,33,41,44,45 and two studies use a combination of both types of samples. 37,47 Collection of the post-travel sample was done within one month after return in 70% of the studies.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…CTX-M group 1 was the most common followed by CTX-M groups 9 and 4. bla SHV and bla TEM were found in 3.0% (95%CI 0-2.0%) and 2.0% (95%CI 0-1.8%) of the isolates, respectively. Enterobacterales with carbapenem-(bla OXA 28,37,45 and bla NDM 28,44,45 ) and colistin-(mcr 48 ) resistance genes were also isolated. Fifty isolates with carbapenem-resistant genes were identified mainly from travellers returning from Southeast Asia and the Indian subcontinent, 28,37,44,45 while the three isolates with colistin-resistant genes were from travellers returning from Vietnam.…”

Section: Aetiology and Resistance Genesmentioning

confidence: 99%

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Risk factors for acquisition of multidrug-resistant Enterobacterales among international travellers: a synthesis of cumulative evidence

Furuya‐Kanamori

Stone

Yakob

et al. 2019

Journal of Travel Medicine

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Background Recent studies have shown that over 50% of people travelling to Southeast Asia return colonized with multidrug-resistant Enterobacterales (MRE) including carbapenemase-producing Enterobacterales. Importation of MRE by travellers and subsequent spread to family members, communities and healthcare facilities poses real risks that have not yet been adequately assessed. This systematic review and meta-analysis aims to quantify the risk factors and interventions for reducing the risk of MRE acquisition among international travellers. Methods A systematic search was conducted in PubMed, Web of Science and Scopus for analytical epidemiological studies containing data post-2000 that assessed the risk factors to acquire and/or interventions to reduce the risk of MRE acquisition in travellers. Two researchers independently screened all the studies and extracted the information, and disagreements were resolved through consensus. The proportions of MRE acquisition by the region of destination and the odds ratio (OR) for the different risk factors and/or interventions were pooled using the inverse variance heterogeneity model. Results A total of 20 studies (5253 travellers from high-income countries) were included in the meta-analysis. South Asia [58.7%; 95% confidence interval (CI), 44.5–72.5%] and Northern Africa (43.9%; 95% CI 37.6–50.3%) were the travel destinations with the highest proportion of MRE acquisition. Inflammatory bowel disease (OR 2.1; 95% CI 1.2–3.8), use of antibiotics (OR 2.4; 95% CI 1.9–3.0), traveller’s diarrhoea (OR 1.7; 95% CI 1.3–2.3) and contact with the healthcare system overseas (OR 1.5; 95% CI 1.1–2.2) were associated with MRE colonization. Vegetarians (OR 1.4; 95% CI 1.0–2.0) and backpackers (OR 1.5; 95% CI 1.2–1.8) were also at increased odds of MRE colonization. Few studies (n = 6) investigated preventive measures and found that consuming only bottled water/beverages, meticulous hand hygiene and probiotics had no protective effect on MRE colonization. Conclusions International travel is an important driver for MRE spread worldwide. Future research needs to identify effective interventions to reduce the risk of MRE acquisition as well as design strategies to reduce local transmission on return.

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Section: Discussionmentioning

confidence: 99%

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Section: Aetiology and Resistance Genesmentioning

confidence: 99%

See 2 more Smart Citations

Risk factors for acquisition of multidrug-resistant Enterobacterales among international travellers: a synthesis of cumulative evidence

Furuya‐Kanamori

Stone

Yakob

et al. 2019

Journal of Travel Medicine

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“…Pour les EPC, de nombreux arguments [7] suggèrent que nous sommes dans la période dite intermédiaire, celle pendant laquelle les patients porteurs ne sont plus uniquement des patients ayant été hospitalisés dans les pays à haute prévalence, mais aussi des patients résidents ou ayant résidé dans ces pays. Des données récentes suggéraient qu'un tiers des porteurs n'avaient jamais rencontré de structure hospitalière et étaient des résidents de pays à haute prévalence [8].…”

Section: De Quoi Parlons-nous ?unclassified

Entérobactéries productrices de carbapénémases en médecine intensive : comment maîtriser le risque ?

Zahar

Mootien

Pilmis

2018

Méd. Intensive Réa.

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La diffusion globale des entérobactéries productrices de carbapénémases principalement au niveau de certaines zones géographiques, dont le pourtour méditerranéen, est une situation préoccupante. Elle doit nous inciter à maintenir notre niveau de vigilance. Trois principaux mécanismes de résistance s’exprimant à des degrés variables sont décrits. Plusieurs critères tels que l’identification de la population à risque, la qualité du diagnostic microbiologique, la gestion du risque ainsi que la diffusion intrahospitalière doivent être maîtrisés. Une politique d’amélioration de l’hygiène des mains, le respect des précautions complémentaires d’hygiène ainsi que la maîtrise de la consommation des antibiotiques sont plus que nécessaires.

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Intra-abdominal abscesses: Microbiological epidemiology and empirical antibiotherapy

Méchaï

Kolakowska²,

Carbonnelle

et al. 2023

Infectious Diseases Now

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Extensively-drug-resistant bacteria carriers among overseas travellers: one-third had not been hospitalized previously

Cited by 10 publications

References 27 publications

Risk factors for acquisition of multidrug-resistant Enterobacterales among international travellers: a synthesis of cumulative evidence

Risk factors for acquisition of multidrug-resistant Enterobacterales among international travellers: a synthesis of cumulative evidence

Entérobactéries productrices de carbapénémases en médecine intensive : comment maîtriser le risque ?

Intra-abdominal abscesses: Microbiological epidemiology and empirical antibiotherapy

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