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High colonization rates of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli in Swiss travellers to South Asia- a prospective observational multicentre cohort study looking at epidemiology, microbiology and risk factors.

Authors :
Kuenzli E
Jaeger VK
Frei R
Neumayr A
DeCrom S
Haller S
Blum J
Widmer AF
Furrer H
Battegay M
Endimiani A
Hatz C
Source :
BMC infectious diseases [BMC Infect Dis] 2014 Oct 01; Vol. 14, pp. 528. Date of Electronic Publication: 2014 Oct 01.
Publication Year :
2014

Abstract

Background: International travel contributes to the worldwide spread of multidrug resistant Gram-negative bacteria. Rates of travel-related faecal colonization with extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae vary for different destinations. Especially travellers returning from the Indian subcontinent show high colonization rates. So far, nothing is known about region-specific risk factors for becoming colonized.<br />Methods: An observational prospective multicentre cohort study investigated travellers to South Asia. Before and after travelling, rectal swabs were screened for third-generation cephalosporin- and carbapenem-resistant Enterobacteriaceae. Participants completed questionnaires to identify risk factors for becoming colonized. Covariates were assessed univariately, followed by a multivariate regression.<br />Results: Hundred and seventy persons were enrolled, the largest data set on travellers to the Indian subcontinent so far. The acquired colonization rate with ESBL-producing Escherichia coli overall was 69.4% (95% CI 62.1-75.9%), being highest in travellers returning from India (86.8%; 95% CI 78.5-95.0%) and lowest in travellers returning from Sri Lanka (34.7%; 95% CI 22.9-48.7%). Associated risk factors were travel destination, length of stay, visiting friends and relatives, and eating ice cream and pastry.<br />Conclusions: High colonization rates with ESBL-producing Enterobacteriaceae were found in travellers returning from South Asia. Though risk factors were identified, a more common source, i.e. environmental, appears to better explain the high colonization rates.

Details

Language :
English
ISSN :
1471-2334
Volume :
14
Database :
MEDLINE
Journal :
BMC infectious diseases
Publication Type :
Academic Journal
Accession number :
25270732
Full Text :
https://doi.org/10.1186/1471-2334-14-528