High rates of antimicrobial drug resistance gene acquisition after international travel, The Netherlands - PubMed (original) (raw)

High rates of antimicrobial drug resistance gene acquisition after international travel, The Netherlands

Christian J H von Wintersdorff et al. Emerg Infect Dis. 2014 Apr.

Abstract

We investigated the effect of international travel on the gut resistome of 122 healthy travelers from the Netherlands by using a targeted metagenomic approach. Our results confirm high acquisition rates of the extended-spectrum β-lactamase encoding gene blaCTX-M, documenting a rise in prevalence from 9.0% before travel to 33.6% after travel (p<0.001). The prevalence of quinolone resistance encoding genes qnrB and qnrS increased from 6.6% and 8.2% before travel to 36.9% and 55.7% after travel, respectively (both p<0.001). Travel to Southeast Asia and the Indian subcontinent was associated with the highest acquisition rates of qnrS and both blaCTX-M and qnrS, respectively. Investigation of the associations between the acquisitions of the blaCTX-M and qnr genes showed that acquisition of a blaCTX-M gene was not associated with that of a qnrB (p = 0.305) or qnrS (p = 0.080) gene. These findings support the increasing evidence that travelers contribute to the spread of antimicrobial drug resistance.

Keywords: CTX-M; ESBL; Enterobacteriaceae; Kluyvera; Shewanella algae; antibacterial; antibiotics; antimicrobial; bacteria; intestinal microbiota; metagenomic; qnrB; qnrS; quinolone; resistance genes; the Netherlands; traveling.

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Figures

Figure 1

Figure 1

Prevalence (%) of antimicrobial drug resistance determinants in fecal samples from 122 healthy travelers from the Netherlands before and after travel, 2010–2012. Statistical significance of the prevalence between the 2 groups was calculated by using the McNemar test for paired samples and is indicated by * (p<0.001).

Figure 2

Figure 2

Relative changes in gene abundance before and after travel for each of 122 healthy travelers from the Netherlands during 2010–2012 for genes cfxA (A), tetM (B), tetQ (C), and ermB (D). Increases are shown with white bars on the positive _y_-axis; decreases are shown in dark gray bars on the negative _y_-axis. Each bar on the _x_-axis represents the change in a different study participant. The travel destination regions of the participants are indicated above the graph. No region is indicated for some travelers who either visited >1 of these regions or visited countries that were not in the defined regions (see Table 2).

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