Division of Infectious Diseases, Massachusetts General Hospital.
Department of Medicine, Harvard Medical School.
Curr Opin Infect Dis. 2021 Oct 1;34(5):423-431. doi: 10.1097/QCO.0000000000000751.
Antimicrobial resistance (AMR) in bacteria poses a major risk to global public health, with many factors contributing to the observed increase in AMR. International travel is one recognized contributor. The purpose of this review is to summarize current knowledge regarding the acquisition, carriage and spread of AMR bacteria by international travelers.
Recent studies have highlighted that travel is an important risk factor for the acquisition of AMR bacteria, with approximately 30% of studied travelers returning with an acquired AMR bacterium. Epidemiological studies have shown there are three major risk factors for acquisition: travel destination, antimicrobial usage and travelers' diarrhea (TD). Analyses have begun to illustrate the AMR genes that are acquired and spread by travelers, risk factors for acquisition and carriage of AMR bacteria, and local transmission of imported AMR organisms.
International travel is a contributor to the acquisition and dissemination of AMR organisms globally. Efforts to reduce the burden of AMR organisms should include a focus on international travelers. Routine genomic surveillance would further elucidate the role of international travel in the global spread of AMR bacteria.
细菌的抗微生物药物耐药性(AMR)对全球公共健康构成重大威胁,许多因素导致 AMR 的观察到的增加。国际旅行是公认的促成因素之一。本综述的目的是总结目前关于国际旅行者获得、携带和传播 AMR 细菌的相关知识。
最近的研究强调旅行是获得 AMR 细菌的重要危险因素,约 30%的研究旅行者返回时携带获得性 AMR 细菌。流行病学研究表明,有三个主要的危险因素:旅行目的地、抗菌药物使用和旅行者腹泻(TD)。分析已经开始阐明旅行者获得和传播的 AMR 基因、获得和携带 AMR 细菌的危险因素,以及进口 AMR 病原体的本地传播。
国际旅行是导致全球获得和传播 AMR 病原体的一个因素。减少 AMR 病原体负担的努力应包括关注国际旅行者。常规的基因组监测将进一步阐明国际旅行在全球 AMR 细菌传播中的作用。