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High Rate of Multidrug-Resistant Gram-Negative Bacilli Carriage and Infection in Hospitalized Returning Travelers: A Cross-Sectional Cohort Study.
J Travel Med. 2015 Sep-Oct; 22(5):292-9.JT

Abstract

BACKGROUND

Carriage of and infection with multidrug-resistant Gram-negative bacilli (MDR-GNB) are a potential cause of concern in travelers with no history of hospitalization abroad.

METHODS

All consecutive returning travelers hospitalized in our department between February 2012 and January 2013 were prospectively screened for MDR-GNB gastrointestinal tract carriage or infection. We compared the prevalence of MDR-GNB in travelers to a non-travelers nonexposed group. Then among the travelers, MDR-GNB carriers were compared to noncarriers to determine risk factors of acquisition of MDR-GNB.

RESULTS

Overall, 359 patients (191 travelers, 168 non-travelers) were included, and 25 (6.4%), including 23 travelers, harbored MDR-GNB. Five travelers had an MDR-GNB infection while 18 were asymptomatic enteric carriers. MDR-GNB carriage or infection was significantly more frequent in travelers (11.0% vs 1.2% for non-travelers, odds ratio (OR) = 11.3, p < 0.001) and in patients born outside France (OR = 1.67; p = 0.03). Among travelers, in multivariate analysis, factors independently associated with MDR-GNB carriage or infection were traveling to Asia (OR = 3.1; p = 0.01) and visiting friends and relatives (VFR) or migrants (OR=3.6; p = 0.01).

CONCLUSIONS

The 10-fold higher prevalence rate of MDR-GNB in travelers raises the issues of systematic screening of all travelers, and of the choice of first line antibiotic therapy when treating urinary tract infections in travelers, especially those VFR, migrants, and those returning from Asia.

Authors+Show Affiliations

Infectious and Tropical Diseases Department, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France. Sorbonne Universités, UPMC Univ Paris, Paris, France.Department of Bacteriology and Hygiene, Sorbonne Universités, Paris, France. Centre d'Immunologie et des Maladies Infectieuses, CIMI, team E13 (Bacteriology), Paris, France. INSERM, U1135, Centre d'Immunologie et des Maladies Infectieuses, CIMI, team E13 (Bacteriology), Paris, France.Infectious and Tropical Diseases Department, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France.INSERM, U1135, Centre d'Immunologie et des Maladies Infectieuses, CIMI, team E13 (Bacteriology), Paris, France.Infectious and Tropical Diseases Department, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France.Infectious and Tropical Diseases Department, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France. Sorbonne Universités, UPMC Univ Paris, Paris, France.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25997830

Citation

Epelboin, Loïc, et al. "High Rate of Multidrug-Resistant Gram-Negative Bacilli Carriage and Infection in Hospitalized Returning Travelers: a Cross-Sectional Cohort Study." Journal of Travel Medicine, vol. 22, no. 5, 2015, pp. 292-9.
Epelboin L, Robert J, Tsyrina-Kouyoumdjian E, et al. High Rate of Multidrug-Resistant Gram-Negative Bacilli Carriage and Infection in Hospitalized Returning Travelers: A Cross-Sectional Cohort Study. J Travel Med. 2015;22(5):292-9.
Epelboin, L., Robert, J., Tsyrina-Kouyoumdjian, E., Laouira, S., Meyssonnier, V., & Caumes, E. (2015). High Rate of Multidrug-Resistant Gram-Negative Bacilli Carriage and Infection in Hospitalized Returning Travelers: A Cross-Sectional Cohort Study. Journal of Travel Medicine, 22(5), 292-9. https://doi.org/10.1111/jtm.12211
Epelboin L, et al. High Rate of Multidrug-Resistant Gram-Negative Bacilli Carriage and Infection in Hospitalized Returning Travelers: a Cross-Sectional Cohort Study. J Travel Med. 2015;22(5):292-9. PubMed PMID: 25997830.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High Rate of Multidrug-Resistant Gram-Negative Bacilli Carriage and Infection in Hospitalized Returning Travelers: A Cross-Sectional Cohort Study. AU - Epelboin,Loïc, AU - Robert,Jérôme, AU - Tsyrina-Kouyoumdjian,Ellina, AU - Laouira,Sonia, AU - Meyssonnier,Vanina, AU - Caumes,Eric, AU - ,, Y1 - 2015/05/22/ PY - 2015/5/23/entrez PY - 2015/5/23/pubmed PY - 2016/6/9/medline SP - 292 EP - 9 JF - Journal of travel medicine JO - J Travel Med VL - 22 IS - 5 N2 - BACKGROUND: Carriage of and infection with multidrug-resistant Gram-negative bacilli (MDR-GNB) are a potential cause of concern in travelers with no history of hospitalization abroad. METHODS: All consecutive returning travelers hospitalized in our department between February 2012 and January 2013 were prospectively screened for MDR-GNB gastrointestinal tract carriage or infection. We compared the prevalence of MDR-GNB in travelers to a non-travelers nonexposed group. Then among the travelers, MDR-GNB carriers were compared to noncarriers to determine risk factors of acquisition of MDR-GNB. RESULTS: Overall, 359 patients (191 travelers, 168 non-travelers) were included, and 25 (6.4%), including 23 travelers, harbored MDR-GNB. Five travelers had an MDR-GNB infection while 18 were asymptomatic enteric carriers. MDR-GNB carriage or infection was significantly more frequent in travelers (11.0% vs 1.2% for non-travelers, odds ratio (OR) = 11.3, p < 0.001) and in patients born outside France (OR = 1.67; p = 0.03). Among travelers, in multivariate analysis, factors independently associated with MDR-GNB carriage or infection were traveling to Asia (OR = 3.1; p = 0.01) and visiting friends and relatives (VFR) or migrants (OR=3.6; p = 0.01). CONCLUSIONS: The 10-fold higher prevalence rate of MDR-GNB in travelers raises the issues of systematic screening of all travelers, and of the choice of first line antibiotic therapy when treating urinary tract infections in travelers, especially those VFR, migrants, and those returning from Asia. SN - 1708-8305 UR - https://www.unboundmedicine.com/medline/citation/25997830/full_citation L2 - https://academic.oup.com/jtm/article-lookup/doi/10.1111/jtm.12211 DB - PRIME DP - Unbound Medicine ER -