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Travel-associated f...
Travel-associated faecal colonization with ESBL-producing Enterobacteriaceae : incidence and risk factors
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- Östholm Balkhed, Åse (författare)
- Östergötlands Läns Landsting,Linköpings universitet,Infektionsmedicin,Hälsouniversitetet,Infektionskliniken i Östergötland
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- Tärnberg, Maria (författare)
- Linköpings universitet,Klinisk mikrobiologi,Hälsouniversitetet
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- Nilsson, Maud (författare)
- Linköpings universitet,Klinisk mikrobiologi,Hälsouniversitetet
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- Nilsson, Lennart E. (författare)
- Linköpings universitet,Klinisk mikrobiologi,Hälsouniversitetet
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- Hanberger, Håkan (författare)
- Östergötlands Läns Landsting,Linköpings universitet,Infektionsmedicin,Hälsouniversitetet,Infektionskliniken i Östergötland
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- Hällgren, Anita (författare)
- Östergötlands Läns Landsting,Linköpings universitet,Infektionsmedicin,Hälsouniversitetet,Infektionskliniken i Östergötland
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(creator_code:org_t)
- 2013-05-14
- 2013
- Engelska.
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Ingår i: Journal of Antimicrobial Chemotherapy. - : Oxford University Press. - 0305-7453 .- 1460-2091. ; 68:9, s. 2144-2153
- Relaterad länk:
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https://liu.diva-por... (primary) (Raw object)
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https://academic.oup...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Objectives To study the acquisition of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) among the faecal flora during travel, with a focus on risk factors, antibiotic susceptibility and ESBL-encoding genes.Methods An observational prospective multicentre cohort study of individuals attending vaccination clinics in south-east Sweden was performed, in which the submission of faecal samples and questionnaires before and after travelling outside Scandinavia was requested. Faecal samples were screened for ESBL-PE by culturing on ChromID ESBL and an in-house method. ESBL-PE was confirmed by phenotypic and genotypic methods. Susceptibility testing was performed with the Etest. Individuals who acquired ESBL-PE during travel (travel-associated carriers) were compared with non-carriers regarding risk factors, and unadjusted and adjusted ORs after manual stepwise elimination were calculated using logistic regression.Results Of 262 enrolled individuals, 2.4% were colonized before travel. Among 226 evaluable participants, ESBL-PE was detected in the post-travel samples from 68 (30%) travellers. The most important risk factor in the final model was the geographic area visited: Indian subcontinent (OR 24.8, P < 0.001), Asia (OR 8.63, P < 0.001) and Africa north of the equator (OR 4.94, P = 0.002). Age and gastrointestinal symptoms also affected the risk significantly. Multiresistance was seen in 77 (66%) of the ESBL-PE isolates, predominantly a combination of reduced susceptibility to third-generation cephalosporins, trimethoprim/sulfamethoxazole and aminoglycosides. The most common species and ESBL-encoding gene were Escherichia coli (90%) and CTX-M (73%), respectively.Conclusion Acquisition of multiresistant ESBL-PE among the faecal flora during international travel is common. The geographical area visited has the highest impact on ESBL-PE acquisition.
Nyckelord
- travel medicine
- CTX-M
- antibiotic resistance
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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