Travel-acquired ESBL-producing Enterobacteriaceae: impact of colonization at individual and community level.
J Travel Med. 2017 Apr 01; 24(suppl_1):S29-S34.JT

Abstract

BACKGROUND

Antibiotic resistance is a rapidly increasing global emergency that calls for action from all of society. Intestinal multidrugresistant (MDR) bacteria have spread worldwide with extended-spectrum beta-lactamase (ESBL) -producing Enterobacteriaceae (ESBL-PE) as the most prevalent type. The millions of travelers annually visiting regions with poor hygiene contribute substantially to this spread. Our review explores the underlying data and discusses the consequences of the colonization.

METHODS

PubMed was searched for relevant literature between January 2010 and August 2016. We focused on articles reporting (1) the rate of ESBL-PE acquisition in a group of travelers recruited before/after international travel, (2) fecal carriage of ESBL-PE as explored by culture and, for part of the studies, (3) analysis of factors predisposing to colonization.

RESULTS

We reviewed a total of 16 studies focusing on travel-acquired ESBL-PE. The acquisition rates reveal that 2070% of visitors to (sub)tropical regions get colonized by ESBL-PE. The main risk factors predisposing to colonization during travel are destination, travelers diarrhea, and antibiotic use.

CONCLUSIONS

While most of those colonized remain asymptomatic, acquisition of ESBL-PE may have consequences both at individual and community level. We discuss current efforts to restrict the spread.

Links

Authors+Show Affiliations

Woerther PL

Laboratory of Medical Microbiology, Institut Gustave-Roussy, Villejuif, France.

Andremont A

INSERM, IAME, UMR 1137, and Université Paris Diderot, Sorbonne Paris Cité, Paris, France APHP, Laboratory of Bacteriology, Hôpital Bichat-Claude Bernard, Paris, France.

Kantele A

Department of Clinical Medicine, University of Helsinki, Helsinki, Finland. Division of Infectious Diseases, Helsinki University Hospital, Inflammation Center, POB 348, FIN-00029, Helsinki, Finland. Unit of Infectious Diseases, Karolinska Institutet, Solna, Stockholm, Sweden.

MeSH

Anti-Bacterial AgentsDiarrheaDrug Resistance, BacterialEnterobacteriaceaeEnterobacteriaceae InfectionsHumansTravelbeta-Lactamases

Pub Type(s)

Journal Article

Review

Language

eng

PubMed ID

28520999

Citation

Woerther, Paul-Louis, et al. "Travel-acquired ESBL-producing Enterobacteriaceae: Impact of Colonization at Individual and Community Level." Journal of Travel Medicine, vol. 24, no. suppl_1, 2017, pp. S29-S34.

Woerther PL, Andremont A, Kantele A. Travel-acquired ESBL-producing Enterobacteriaceae: impact of colonization at individual and community level. J Travel Med. 2017;24(suppl_1):S29-S34.

Woerther, P. L., Andremont, A., & Kantele, A. (2017). Travel-acquired ESBL-producing Enterobacteriaceae: impact of colonization at individual and community level. Journal of Travel Medicine, 24(suppl_1), S29-S34. https://doi.org/10.1093/jtm/taw101

Woerther PL, Andremont A, Kantele A. Travel-acquired ESBL-producing Enterobacteriaceae: Impact of Colonization at Individual and Community Level. J Travel Med. 2017 Apr 1;24(suppl_1):S29-S34. PubMed PMID: 28520999.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Travel-acquired ESBL-producing Enterobacteriaceae: impact of colonization at individual and community level. AU - Woerther,Paul-Louis, AU - Andremont,Antoine, AU - Kantele,Anu, PY - 2016/12/20/accepted PY - 2017/5/19/entrez PY - 2017/5/19/pubmed PY - 2018/2/27/medline KW - ESBL KW - ESBL-PE KW - Escherichia coli KW - Extended-spectrum β-lactamase KW - MDR KW - TD KW - antibiotics KW - colonization KW - diarrhea KW - multi-drugresistant bacteria KW - travel KW - traveller KW - travellers′ SP - S29 EP - S34 JF - Journal of travel medicine JO - J Travel Med VL - 24 IS - suppl_1 N2 - BACKGROUND: Antibiotic resistance is a rapidly increasing global emergency that calls for action from all of society. Intestinal multidrugresistant (MDR) bacteria have spread worldwide with extended-spectrum beta-lactamase (ESBL) -producing Enterobacteriaceae (ESBL-PE) as the most prevalent type. The millions of travelers annually visiting regions with poor hygiene contribute substantially to this spread. Our review explores the underlying data and discusses the consequences of the colonization. METHODS: PubMed was searched for relevant literature between January 2010 and August 2016. We focused on articles reporting (1) the rate of ESBL-PE acquisition in a group of travelers recruited before/after international travel, (2) fecal carriage of ESBL-PE as explored by culture and, for part of the studies, (3) analysis of factors predisposing to colonization. RESULTS: We reviewed a total of 16 studies focusing on travel-acquired ESBL-PE. The acquisition rates reveal that 2070% of visitors to (sub)tropical regions get colonized by ESBL-PE. The main risk factors predisposing to colonization during travel are destination, travelers diarrhea, and antibiotic use. CONCLUSIONS: While most of those colonized remain asymptomatic, acquisition of ESBL-PE may have consequences both at individual and community level. We discuss current efforts to restrict the spread. SN - 1708-8305 UR - https://www.unboundmedicine.com/medline/citation/28520999/full_citation L2 - https://academic.oup.com/jtm/article-lookup/doi/10.1093/jtm/taw101 DB - PRIME DP - Unbound Medicine ER -

Tags

Travel-acquired ESBL-producing Enterobacteriaceae: impact of colonization at individual and community level.J Travel Med. 2017 Apr 01; 24(suppl_1):S29-S34.JT