Infectious Diseases and Microbiology, The Canberra Hospital, Australian National University Medical School, P.O. Box 11, Woden, ACT 2606, Australia.
Eur J Clin Microbiol Infect Dis. 2010 Dec;29(12):1501-6. doi: 10.1007/s10096-010-1031-y. Epub 2010 Sep 12.
Antimicrobial resistance among community-acquired isolates of Escherichia coli is increasing globally, with international travel emerging as a risk for colonisation and infection. The aim was to determine the rate and duration of colonisation with resistant E. coli following international travel. One hundred and two adult hospital staff and contacts from Canberra, Australia, submitted perianal/rectal swabs before and following international travel. Swabs were cultured selectively to identify E. coli resistant to gentamicin, ciprofloxacin and/or third-generation cephalosporins. Those with resistant E. coli post-travel were tested monthly for persistent colonisation. Colonisation with antibiotic-resistant E. coli increased significantly from 7.8% (95% confidence interval [CI] 3.8-14.9) pre-travel to 49% (95% CI 39.5-58.6) post-travel. Those colonised were more likely to have taken antibiotics whilst travelling; however, travel remained a risk independent of antibiotic use. Colonisation with resistant E. coli occurred most frequently following travel to Asia. While over half of those carrying resistant E. coli post-travel had no detectable resistant strains two months after their return, at least 18% remained colonised at six months. Colonisation with antibiotic-resistant E. coli occurs commonly after international travel, and can be persistent. Medical practitioners should be aware of this risk, particularly when managing patients with suspected Gram-negative sepsis.
社区获得性大肠杆菌的抗生素耐药性在全球范围内不断增加，国际旅行成为定植和感染的风险因素。本研究旨在确定国际旅行后携带耐药大肠杆菌的定植率和持续时间。102 名来自澳大利亚堪培拉的成年医院工作人员和接触者在国际旅行前后提交了肛周/直肠拭子。拭子经选择性培养以鉴定对庆大霉素、环丙沙星和/或第三代头孢菌素耐药的大肠杆菌。那些旅行后携带耐药大肠杆菌的人每月接受一次持续性定植检测。旅行后，携带抗生素耐药大肠杆菌的定植率从旅行前的 7.8%（95%置信区间 [CI] 3.8-14.9）显著增加到 49%（95% CI 39.5-58.6）。那些定植的人更有可能在旅行期间使用抗生素；然而，即使不使用抗生素，旅行仍然是一个风险因素。旅行后最常发生耐药大肠杆菌定植的情况是前往亚洲。尽管旅行后携带耐药大肠杆菌的人中，有超过一半的人在返回后两个月内没有检测到耐药菌株，但至少有 18%的人在六个月后仍处于定植状态。国际旅行后，抗生素耐药大肠杆菌定植很常见，且可能持续存在。医务人员应意识到这种风险，特别是在治疗疑似革兰氏阴性菌败血症的患者时。
