title: High rates of antimicrobial drug resistance gene acquisition after international travel, The Netherlands.
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.
authors.forename: Christian J H
authors.initials: CJ
authors.lastname: von Wintersdorff
authors.forename: John
authors.initials: J
authors.lastname: Penders
authors.forename: Ellen E
authors.initials: EE
authors.lastname: Stobberingh
authors.forename: Astrid M L
authors.initials: AM
authors.lastname: Oude Lashof
authors.forename: Christian J P A
authors.initials: CJ
authors.lastname: Hoebe
authors.forename: Paul H M
authors.initials: PH
authors.lastname: Savelkoul
authors.forename: Petra F G
authors.initials: PF
authors.lastname: Wolffs
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001426:Bacterial Proteins / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D005260:Female; D041981:Gastrointestinal Tract / Q000382:microbiology; D005798:Genes, Bacterial / Q000235:genetics; D006801:Humans; D008297:Male; D056186:Metagenomics / Q000379:methods; D008875:Middle Aged; D009426:Netherlands; D015995:Prevalence; D015363:Quinolones / Q000494:pharmacology; D014195:Travel; D055815:Young Adult; D001618:beta-Lactamases / Q000235:genetics
chemical_list: D001426:Bacterial Proteins; D015363:Quinolones; D001618:beta-Lactamases
keywords: CTX-M; ESBL; Enterobacteriaceae; Kluyvera; Shewanella algae; antibacterial; antibiotics; antimicrobial; bacteria; intestinal microbiota; metagenomic; qnrB; qnrS; quinolone; resistance genes; the Netherlands; traveling