High Rate of Acquisition but Short Duration of Carriage of Multidrug-Resistant Enterobacteriaceae After Travel to the Tropics

作者：Étienne Ruppé, Laurence Armand-Lefèvre, Candice Estellat, Paul‐Henri Consigny, Assiya El Mniai, Yacine Boussadia, Catherine Goujon, Pascal Ralaimazava, Pauline Campa, Pierre‐Marie Girard, Benjamin Wyplosz, Daniel Vittecoq, Olivier Bouchaud, Guillaume Loup, Gilles Pialoux, Marion Perrier, Ingrid Wieder, Nabila Moussa, Marina Esposito‐Farèse, Isabelle Hoffmann, B. Coignard, Jean‐Christophe Lucet, Antoine Andremont, Sophie Matheron · 发表于：Clinical Infectious Diseases · 年份：2015 · DOI：10.1093/cid/civ333 · 被引用次数：282 · 研究领域：Travel-related health issues、Antibiotic Resistance in Bacteria、Escherichia coli research studies

BACKGROUND: Multidrug-resistant Enterobacteriaceae (MRE) are widespread in the community, especially in tropical regions. Travelers are at risk of acquiring MRE in these regions, but the precise extent of the problem is not known. METHODS: From February 2012 to April 2013, travelers attending 6 international vaccination centers in the Paris area prior to traveling to tropical regions were asked to provide a fecal sample before and after their trip. Those found to have acquired MRE were asked to send fecal samples 1, 2, 3, 6, and 12 months after their return, or until MRE was no longer detected. The fecal relative abundance of MRE among all Enterobacteriaceae was determined in each carrier. RESULTS: Among 824 participating travelers, 574 provided fecal samples before and after travel and were not MRE carriers before departure. Of these, 292 (50.9%) acquired an average of 1.8 MRE. Three travelers (0.5%) acquired carbapenemase-producing Enterobacteriaceae. The acquisition rate was higher in Asia (142/196 [72.4%]) than in sub-Saharan Africa (93/195 [47.7%]) or Latin America (57/183 [31.1%]). MRE acquisition was associated with the type of travel, diarrhea, and exposure to β-lactams during the travel. Three months after return, 4.7% of the travelers carried MRE. Carriage lasted longer in travelers returning from Asia and in travelers with a high relative abundance of MRE at return. CONCLUSIONS: MRE acquisition is very frequent among travelers to tropical regions. Travel to these r...