title: Prolonged carriage and potential onward transmission of carbapenemase-producing Enterobacteriaceae in Dutch travelers.
abstract: OBJECTIVE
  The aim was to study acquisition and persistence of carbapenemase-producing Enterobacteriaceae (CPE) among travelers.
  
  
  METHODS
  Stools from 2001 travelers and 215 nontraveling household members, collected before and immediately post-travel as well as 1, 3, 6 and 12 months upon return, were screened for CPE.
  
  
  RESULTS
  Five travelers, all visiting Asia outside the Indian subcontinent, acquired CPE. One traveler persistently carried the same OXA-244 CPE up to 6 months post-travel. Three months after travel, her co-traveling spouse also became positive for this OXA-244 CPE strain, suggesting clonal transmission within this household.
  
  
  CONCLUSIONS
  Acquisition of CPE is not restricted to travelers to the Indian subcontinent and/or to travelers seeking healthcare during travel and can persist up to at least 6 months post-travel.
authors.affiliation: Academic Medical Center, Department of Medical Microbiology, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Jarne M
authors.initials: JM
authors.lastname: van Hattem
authors.affiliation: Erasmus University Medical Center, Department of Medical Microbiology & Infectious Diseases, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
authors.forename: Maris S
authors.initials: MS
authors.lastname: Arcilla
authors.affiliation: Utrecht University, Department of Mathematics, Faculty of Science, Budapestlaan 6, 3584 CD Utrecht, The Netherlands.
authors.forename: Martin Cj
authors.initials: MC
authors.lastname: Bootsma
authors.affiliation: Havenziekenhuis - Institute for Tropical Diseases, Department of Internal Medicine, Haringvliet 2, 3011 TD Rotterdam, The Netherlands.
authors.forename: Perry J
authors.initials: PJ
authors.lastname: van Genderen
authors.affiliation: Academic Medical Center, Center for Tropical Medicine & Travel Medicine, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Abraham
authors.initials: A
authors.lastname: Goorhuis
authors.affiliation: Academic Medical Center, Center for Tropical Medicine & Travel Medicine, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Martin P
authors.initials: MP
authors.lastname: Grobusch
authors.affiliation: Havenziekenhuis - Travel Clinic Harbour Hospital, Haringvliet 2, 3011 TD Rotterdam, The Netherlands.
authors.forename: Nicky
authors.initials: N
authors.lastname: Molhoek
authors.affiliation: Maastricht University Medical Center, NUTRIM School for Nutrition & Translational Research in Metabolism and Caphri School for Public Health & Primary Care, Department of Medical Microbiology, PO 5800, 6202 AZ Maastricht, The Netherlands.
authors.forename: Astrid Ml
authors.initials: AM
authors.lastname: Oude Lashof
authors.affiliation: Academic Medical Center, Department of Medical Microbiology, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Constance
authors.initials: C
authors.lastname: Schultsz
authors.affiliation: Maastricht University Medical Center, NUTRIM School for Nutrition & Translational Research in Metabolism and Caphri School for Public Health & Primary Care, Department of Medical Microbiology, PO 5800, 6202 AZ Maastricht, The Netherlands.
authors.forename: Ellen E
authors.initials: EE
authors.lastname: Stobberingh
authors.affiliation: Erasmus University Medical Center, Department of Medical Microbiology & Infectious Diseases, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
authors.forename: Henri A
authors.initials: HA
authors.lastname: Verbrugh
authors.affiliation: Academic Medical Center, Department of Medical Microbiology, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Menno D
authors.initials: MD
authors.lastname: de Jong
authors.affiliation: Erasmus University Medical Center, Department of Medical Microbiology & Infectious Diseases, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
authors.forename: Damian C
authors.initials: DC
authors.lastname: Melles
authors.affiliation: Maastricht University Medical Center, NUTRIM School for Nutrition & Translational Research in Metabolism and Caphri School for Public Health & Primary Care, Department of Medical Microbiology, PO 5800, 6202 AZ Maastricht, The Netherlands.
authors.forename: John
authors.initials: J
authors.lastname: Penders
mesh_terms: D000328:Adult; D001208:Asia; D001426:Bacterial Proteins / Q000096:biosynthesis*; D002353:Carrier State / Q000382:microbiology*; D004755:Enterobacteriaceae / Q000187:drug effects / Q000201:enzymology* / Q000302:isolation & purification / Q000502:physiology*; D004756:Enterobacteriaceae Infections / Q000208:ethnology / Q000382:microbiology / Q000635:transmission*; D005191:Family Characteristics; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D015378:Imipenem / Q000494:pharmacology; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D013997:Time Factors; D014195:Travel; D055815:Young Adult; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D001426:Bacterial Proteins; D015378:Imipenem; D001618:beta-Lactamases; C063912:carbapenemase
keywords: Enterobacteriaceae; carbapenemases; transmission; travel