Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
University Health Service, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China.
J Travel Med. 2023 Oct 31;30(6). doi: 10.1093/jtm/taad027.
International travel increases the risk of acquisition of antibiotic-resistant bacteria and antibiotic resistance genes (ARGs). Previous studies have characterized the changes in the gut microbiome and resistome of Western travellers; however, information on non-Western populations and the effects of travel-related risk factors on the gut microbiome and resistome remains limited.
We conducted a prospective observational study on a cohort of 90 healthy Chinese adult residents of Hong Kong. We characterized the microbiome and resistome in stools collected from the subjects before and after travelling to diverse international locations using shotgun metagenomic sequencing and examined their associations with travel-related variables.
Our results showed that travel neither significantly changed the taxonomic composition of the faecal microbiota nor altered the alpha (Shannon) or beta diversity of the faecal microbiome or resistome. However, travel significantly increased the number of ARGs. Ten ARGs, including aadA, TEM, mgrB, mphA, qnrS9 and tetR, were significantly enriched in relative abundance after travel, eight of which were detected in metagenomic bins belonging to Escherichia/Shigella flexneri in the post-trip samples. In sum, 30 ARGs significantly increased in prevalence after travel, with the largest changes observed in tetD and a few qnrS variants (qnrS9, qnrS and qnrS8). We found that travel to low- or middle-income countries, or Africa or Southeast Asia, increased the number of ARG subtypes, whereas travel to low- or middle-income countries and the use of alcohol-based hand sanitizer (ABHS) or doxycycline as antimalarial prophylaxis during travel resulted in increased changes in the beta diversity of the faecal resistome.
Our study highlights travel to low- or middle-income countries, Africa or Southeast Asia, a long travel duration, or the use of ABHS or doxycycline as antimalarial prophylaxis as important risk factors for the acquisition/enrichment of ARGs during international travel.
国际旅行会增加获得抗生素耐药菌和抗生素耐药基因（ARGs）的风险。先前的研究已经描述了西方旅行者肠道微生物组和耐药组的变化；然而，关于非西方人群的信息以及旅行相关风险因素对肠道微生物组和耐药组的影响仍然有限。
我们对 90 名香港成年常住居民进行了一项前瞻性观察性研究。我们使用宏基因组测序技术对旅行者旅行前后采集的粪便样本中的微生物组和耐药组进行了特征描述，并研究了它们与旅行相关变量的相关性。
我们的结果表明，旅行既没有显著改变粪便微生物群的分类组成，也没有改变粪便微生物组或耐药组的 alpha（香农）或 beta 多样性。然而，旅行确实增加了抗生素耐药基因的数量。在旅行后，10 种抗生素耐药基因（aadA、TEM、mgrB、mphA、qnrS9 和 tetR）的相对丰度显著增加，其中 8 种在旅行后样本中属于埃希氏菌/志贺氏菌属的宏基因组盒中被检测到。总的来说，有 30 种抗生素耐药基因在旅行后显著增加，其中 tetD 和少数 qnrS 变体（qnrS9、qnrS 和 qnrS8）的变化最大。我们发现，前往低收入或中等收入国家或非洲或东南亚旅行会增加抗生素耐药基因亚型的数量，而前往低收入或中等收入国家旅行以及在旅行期间使用酒精基手部消毒剂（ABHS）或强力霉素作为抗疟预防药物会导致粪便耐药组 beta 多样性的变化增加。
我们的研究强调了前往低收入或中等收入国家、非洲或东南亚、旅行时间长、或使用 ABHS 或强力霉素作为抗疟预防药物等是国际旅行中获得/富集抗生素耐药基因的重要风险因素。
