Division of Infectious Disease, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
PLoS One. 2018 Oct 24;13(10):e0205504. doi: 10.1371/journal.pone.0205504. eCollection 2018.
In a previous study, we found that 30% of individuals travelling outside Scandinavia acquired extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) in their faecal flora. The aim of this study was to determine the duration of travel-associated faecal colonisation with ESBL-PE, to assess risk factors for prolonged colonisation and to detect changes in antibiotic susceptibility during prolonged colonisation.
Individuals with travel-associated colonisation with ESBL-PE submitted faecal samples every 3rd month over a one-year period. A questionnaire was completed at the beginning and end of follow-up. All specimens were analysed for ESBL-PE, and all isolates underwent confirmatory phenotype testing as well as molecular characterisation of ESBL-genes. Minimum inhibitory concentrations (MIC) for beta-lactam and non-beta-lactam agents were determined using the Etest.
Among 64 participants with travel-associated colonisation with ESBL-PE, sustained carriage was seen in 20/63 (32%), 16/63 (25%), 9/63 (14%) and 7/64 (11%) at 3, 6, 9 and 12 months after return from their journey, respectively. The majority, 44 (69%) of travellers were short-term carriers with ESBL-PE only detected in the initial post-travel stool sample. Evaluation of risk factors demonstrated a decreased risk of becoming a long-term carrier among travellers with diarrhoea while abroad and a history of a new journey during the follow-up period. High susceptible rates were demonstrated to carbapenems (97-100%), temocillin (95%), mecillinam (97%), amikacin (98%), fosfomycin (98%), nitrofurantoin (99%) and tigecycline (97%).
Travel-associated faecal colonisation with ESBL-PE appears to be transient and generally brief. Diarrhoea while abroad or a new trip abroad during the follow-up period decreased the risk of becoming a long-term carrier. Only 11% of travellers who acquired ESBL-PE during their travels had sustained colonisation 12 months after return.
在之前的一项研究中，我们发现，30%前往斯堪的纳维亚以外地区旅行的人在其粪便菌群中携带了产超广谱β-内酰胺酶的肠杆菌科细菌（ESBL-PE）。本研究的目的是确定旅行相关的 ESBL-PE 粪便定植的持续时间，评估延长定植的危险因素，并检测延长定植期间抗生素敏感性的变化。
64 名携带 ESBL-PE 的旅行者在一年期间每 3 个月提交一次粪便样本。在随访开始和结束时完成一份问卷。所有标本均进行 ESBL-PE 分析，所有分离株均进行确证表型试验以及 ESBL 基因的分子特征分析。使用 Etest 测定β-内酰胺类和非β-内酰胺类药物的最低抑菌浓度（MIC）。
在 64 名携带 ESBL-PE 的旅行者中，20/63（32%）、16/63（25%）、9/63（14%）和 7/64（11%）分别在旅行结束后 3、6、9 和 12 个月时持续携带 ESBL-PE。大多数旅行者（69%）为短期携带者，仅在旅行后的初始粪便样本中检测到 ESBL-PE。危险因素评估显示，在国外旅行时出现腹泻和随访期间有新旅行的旅行者成为长期携带者的风险降低。碳青霉烯类（97-100%）、替卡西林（95%）、美西林（97%）、阿米卡星（98%）、磷霉素（98%）、呋喃妥因（99%）和替加环素（97%）对旅行者的敏感率较高。
旅行相关的 ESBL-PE 粪便定植似乎是短暂的，通常是短暂的。国外旅行时出现腹泻或随访期间有新的国外旅行会降低成为长期携带者的风险。在旅行中获得 ESBL-PE 的旅行者中，只有 11%在返回后 12 个月仍有持续定植。
