Dual PA/MPH Program

Title

The Silent Souvenir - Are travelers at increased risk of Antibiotic Resistant Enterobacteriaceae (ARE) colonization?: A Systematic Review

Poster Number

38

Document Type

Poster

Status

Graduate Student - Masters

Abstract Category

Environmental and Occupational Health

Keywords

enterobacteriaceae, travel, antibiotic resistance, navigation guide, mobilized colistin resistance

Publication Date

Spring 2018

Abstract

BACKGROUND: With the recent introduction of mobilized resistance genes and the growing public health concern for antibiotic resistance, the role of tourism in the global spread of superbugs has not been well established.

OBJECTIVES: The primary objective of this review was to determine the association between foreign travel and risk of gut-colonization by antimicrobial-resistant Enterobacteriaceae (ARE).

METHODS: A thorough systematic literature review was conducted on the existing body of evidence. A total of 18 prospective cohort studies were analyzed using the Navigation Guide methodology. Included studies analyzed either fecal samples and/or rectal swabs both pre- and post-travel to determine incidence of colonization with antimicrobial-resistant Enterobacteriaceae. Questionnaires were obtained to determine travel behaviors and identify risk factors for acquisition.

DISCUSSION: Key risk factors for colonization included travel to the Indian Subcontinent and Asia, as well as traveler’s diarrhea and antibiotic use during travel. The prevalence of bacteria with mobilized colistin resistance found inFraser healthy travelers was profound, given that this gene was discovered just 2 years prior to this review.

CONCLUSION: Overall, increased acquisition rates of antimicrobial-resistant Enterobacteriaceae among healthy travelers were noted in this review. Larger, more homogenous studies need to be performed in order to influence key antibiotic use policy reform on a global scale.

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Creative Commons License
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The Silent Souvenir - Are travelers at increased risk of Antibiotic Resistant Enterobacteriaceae (ARE) colonization?: A Systematic Review

BACKGROUND: With the recent introduction of mobilized resistance genes and the growing public health concern for antibiotic resistance, the role of tourism in the global spread of superbugs has not been well established.

OBJECTIVES: The primary objective of this review was to determine the association between foreign travel and risk of gut-colonization by antimicrobial-resistant Enterobacteriaceae (ARE).

METHODS: A thorough systematic literature review was conducted on the existing body of evidence. A total of 18 prospective cohort studies were analyzed using the Navigation Guide methodology. Included studies analyzed either fecal samples and/or rectal swabs both pre- and post-travel to determine incidence of colonization with antimicrobial-resistant Enterobacteriaceae. Questionnaires were obtained to determine travel behaviors and identify risk factors for acquisition.

DISCUSSION: Key risk factors for colonization included travel to the Indian Subcontinent and Asia, as well as traveler’s diarrhea and antibiotic use during travel. The prevalence of bacteria with mobilized colistin resistance found inFraser healthy travelers was profound, given that this gene was discovered just 2 years prior to this review.

CONCLUSION: Overall, increased acquisition rates of antimicrobial-resistant Enterobacteriaceae among healthy travelers were noted in this review. Larger, more homogenous studies need to be performed in order to influence key antibiotic use policy reform on a global scale.