Gert van der Hoek
In Memoriam - Editor, Senior Moderator
EID Journal Volume 19, Number 8—August 2013
Extended-Spectrum β-Lactamase–producing Enterobacteriaceae among Travelers from the Netherlands
Abstract
A prospective cohort study was performed among travelers from the Netherlands to investigate the acquisition of carbapenemase-producing Enterobacteriaceae (CP-E) and extended-spectrum β-lactamase–producing Enterobacteriaceae (ESBL-E) and associated risk factors.
Questionnaires were administered and rectal swabs were collected and tested before and after return. Of 370 travelers, 32 (8.6%) were colonized with ESBL-E before travel; 113 (30.5%) acquired an ESBL-E during travel, and 26 were still colonized 6 months after return.
No CP-E were found.
Independent risk factors for ESBL-E acquisition were travel to South and East Asia. Multilocus sequence typing showed extensive genetic diversity among Escherichia coli. Predominant ESBLs were CTX-M enzymes.
The acquisition rate, 30.5%, of ESBL-E in travelers from the Netherlands to all destinations studied was high. Active surveillance for ESBL-E and CP-E and contact isolation precautions may be recommended at admission to medical facilities for patients who traveled to Asia during the previous 6 months.
Full article
Interesting comment by Andreas Voss:
While the fact that travelers bring home MDRO's isn't new this study has a few aspects older ones did not cover. Read the whole article or have a look at the results slide below, but what I found most interesting was the fact that 57% of the cases the ESBL-pos isolate found 6 months after the return from his/her journey with different from the one at return.
So far, I always believed that we are colonized with the one strain for a very long time, but we might pick-up new once or our guts transfer plasmids from one strain/species to another. In any case seems important, also with regard to the time, we should "flag" a patient as ESBL-carrier.
Extended-Spectrum β-Lactamase–producing Enterobacteriaceae among Travelers from the Netherlands
Abstract
A prospective cohort study was performed among travelers from the Netherlands to investigate the acquisition of carbapenemase-producing Enterobacteriaceae (CP-E) and extended-spectrum β-lactamase–producing Enterobacteriaceae (ESBL-E) and associated risk factors.
Questionnaires were administered and rectal swabs were collected and tested before and after return. Of 370 travelers, 32 (8.6%) were colonized with ESBL-E before travel; 113 (30.5%) acquired an ESBL-E during travel, and 26 were still colonized 6 months after return.
No CP-E were found.
Independent risk factors for ESBL-E acquisition were travel to South and East Asia. Multilocus sequence typing showed extensive genetic diversity among Escherichia coli. Predominant ESBLs were CTX-M enzymes.
The acquisition rate, 30.5%, of ESBL-E in travelers from the Netherlands to all destinations studied was high. Active surveillance for ESBL-E and CP-E and contact isolation precautions may be recommended at admission to medical facilities for patients who traveled to Asia during the previous 6 months.
Full article
Interesting comment by Andreas Voss:
While the fact that travelers bring home MDRO's isn't new this study has a few aspects older ones did not cover. Read the whole article or have a look at the results slide below, but what I found most interesting was the fact that 57% of the cases the ESBL-pos isolate found 6 months after the return from his/her journey with different from the one at return.
So far, I always believed that we are colonized with the one strain for a very long time, but we might pick-up new once or our guts transfer plasmids from one strain/species to another. In any case seems important, also with regard to the time, we should "flag" a patient as ESBL-carrier.