title: 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 swab samples were collected and tested before and after traveler return. Of 370 travelers, 32 (8.6%) were colonized with ESBL-E before trave,; 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.
authors.affiliation: Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands. s.paltansing@lumc.nl
authors.forename: Sunita
authors.initials: S
authors.lastname: Paltansing
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Vlot
authors.forename: Margriet E M
authors.initials: ME
authors.lastname: Kraakman
authors.forename: Romy
authors.initials: R
authors.lastname: Mesman
authors.forename: Marguerite L
authors.initials: ML
authors.lastname: Bruijning
authors.forename: Alexandra T
authors.initials: AT
authors.lastname: Bernards
authors.forename: Leo G
authors.initials: LG
authors.lastname: Visser
authors.forename: Karin Ellen
authors.initials: KE
authors.lastname: Veldkamp
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D052978:Disk Diffusion Antimicrobial Tests; D024901:Drug Resistance, Multiple, Bacterial; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology*; D029968:Escherichia coli Proteins / Q000096:biosynthesis / Q000235:genetics*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D058885:Multilocus Sequence Typing; D009426:Netherlands; D011446:Prospective Studies; D012307:Risk Factors; D014195:Travel; D055815:Young Adult; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000096:biosynthesis / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D029968:Escherichia coli Proteins; C055184:beta-lactamase TEM-3; D001618:beta-Lactamases
keywords: CP-E; ESBL; ESBL-E; Enterobacteriaceae; Escherichia coli; Holland; Klebsiella pneumoniae; antibiotic; antimicrobial resistance; bacteria; carbapenemase; extended-spectrum β-lactamase; sequence type; the Netherlands; travel health; travelers