Import and spread of extended-spectrum β-lactamase-producing Enterobacteriaceae by international travellers (COMBAT study): a prospective, multicentre cohort study

Abstract

Netherlands Organisation for Health Research and Development (ZonMw).

Rates of colonization with extended-spectrum β-lactamase-producing Escherichia coli in Canadian travellers returning from South Asia: a cross-sectional assessment

“…In that study, the strongest predictors for acquisition of ESBL-producing E. coli were geographic destination (notably South Asia), antibiotic use during travel, traveller's diarrhea and pre-existing chronic bowel disease. 18 Eating at street food stalls, consumption of raw vegetables, contact with orphan children, staying in a hostel or guest house, visiting local markets and staying in rural areas were additional strong predictors of colonization with ESBL-producing E. coli.…”

“…17 The largest and most comprehensive travel study investigating multidrug-resistant E. coli colonization among returning travellers was performed in the Netherlands. 18 The authors studied more than 1800 travellers who were negative for ESBL-producing E. coli before travel; of Enrolled in study n = 149 (71%)…”

“…18 Of the 181 travellers who visited South Asia, 136 (75.1%, CI 68.4%-80.9%) were positive for ESBL-producing E. coli upon their return to the Netherlands. In that study, the strongest predictors for acquisition of ESBL-producing E. coli were geographic destination (notably South Asia), antibiotic use during travel, traveller's diarrhea and pre-existing chronic bowel disease.…”

Bacterial sepsis

“…A prospective study from 2017 [36] showed that up to 75% of the investigated travelers returning from, e. g., India, had acquired Enterobacteriaceae, which produce broad-spectrum β-lactamases. Although these tourists are primarily symptom-free carriers of MDR pathogens, these bacteria could become relevant in the case of an infection (e. g., abdominal infection).…”

Antipathy against SDD is justified: Yes

“…Acquisition rates of ESBL-PE by European travelers are about 30% in America, 40% in Africa, and 70% in Asia [4]. ESBL-PE acquisition after travel is able to diffuse to other family members in 12% of the cases [5]. ESBL-PE carriage in healthy people is 14% worldwide on average and increases by more than 5% per year [6].…”