Acquisition and Long-term Carriage of Multidrug-Resistant Organisms in US International Travelers

Colin J Worby; Ashlee M Earl; Sarah E Turbett; Margaret Becker; Sowmya R Rao; Elizabeth Oliver; Allison Taylor Walker; Maroya Walters; Paul Kelly; Daniel T Leung; Mark Knouse; Stefan H F Hagmann; Edward T Ryan; Regina C LaRocque

doi:10.1093/ofid/ofaa543

Acquisition and Long-term Carriage of Multidrug-Resistant Organisms in US International Travelers

Open Forum Infect Dis. 2020 Dec 21;7(12):ofaa543. doi: 10.1093/ofid/ofaa543. eCollection 2020 Dec.

Authors

Colin J Worby¹, Ashlee M Earl¹, Sarah E Turbett^{2

3

4}, Margaret Becker⁴, Sowmya R Rao^{5

6}, Elizabeth Oliver², Allison Taylor Walker⁷, Maroya Walters⁸, Paul Kelly⁹, Daniel T Leung¹⁰, Mark Knouse¹¹, Stefan H F Hagmann¹², Edward T Ryan^{2

3

13}, Regina C LaRocque^{2

3}

Affiliations

¹ Infectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA.
² Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA.
³ Harvard Medical School, Boston, Massachusetts, USA.
⁴ Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA.
⁵ Biostatistics Center, Massachusetts General Hospital, Boston, Massachusetts, USA.
⁶ Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA.
⁷ Division of Global Migration and Quarantine, Travelers' Health Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
⁸ Division of Healthcare Quality Promotion, Prevention and Response Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
⁹ Bronx Care Center, New York, New York, USA.
¹⁰ University of Utah, Salt Lake City, Utah, USA.
¹¹ Lehigh Valley Medical Center, Allentown, Pennsylvania, USA.
¹² Cohen Children's Medical Center, New Hyde Park, New York, USA.
¹³ Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA.

Abstract

We performed prospective screening of stool for multidrug-resistant organisms from 608 US international travelers and identified an acquisition rate of 38% following travel. Carriage rates remained significantly elevated for at least 6 months post-travel. Travel-related diarrhea was a risk factor for acquisition, as well as for long-term carriage upon return.

Keywords: CRE; ESBL; antibiotic resistance; mcr; travelers’ health.

Abstract

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