Global geographic trends in antimicrobial resistance: the role of international travel

作者：Isabel Frost, Thomas P. Van Boeckel, João Pires, Jessica Craig, Ramanan Laxminarayan · 发表于：Journal of Travel Medicine · 年份：2019 · DOI：10.1093/jtm/taz036 · 被引用次数：355 · 研究领域：Travel-related health issues、Antibiotic Use and Resistance、Antibiotic Resistance in Bacteria

BACKGROUND: Rising antimicrobial resistance (AMR) is a threat to modern medicine, and increasing international mobility facilitates the spread of AMR. Infections with resistant organisms have higher morbidity and mortality, are costlier to treat, result in longer hospital stays and place a greater burden on health systems than infections caused by susceptible organisms. Here we review the role of travel in the international dissemination of AMR and consider actions at the levels of travelers, travel medicine practitioners and policymakers that would mitigate this threat. RESULTS: Resistant pathogens do not recognize international borders; travelers to areas with high AMR prevalence are likely to be exposed to resistant bacteria and return to their home countries colonized. Medical tourists go between health facilities with drastically different rates of AMR, potentially transmitting highly resistant strains.Drug-resistant bacteria have been found in every continent; however, differences between countries in the prevalence of AMR depend on multiple factors. These include levels of antibiotic consumption (including inappropriate use), access to clean water, adequate sanitation, vaccination coverage, the availability of quality healthcare and access to high-quality medical products. CONCLUSIONS: Travelers to areas with high levels of AMR should have vaccines up to date, be aware of ways of treating and preventing travelers' diarrhea (other than antibiotic use) and be informed on...