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Multidrug-resistant bacteria and travel

Serge De Vallière1,2

  • 1Centre de vaccination et médecine des voyages, Policlinique médicale universitaire, CHUV, 1011 Lausanne.

Revue Medicale Suisse
|June 20, 2017
PubMed

Insights

Travelers to tropical regions risk colonization by multidrug-resistant bacteria. Factors like destination and diarrhea increase this risk, necessitating awareness for returning patients.

Area of Science:

  • Global Health
  • Infectious Diseases
  • Microbiology

Background:

  • Antimicrobial resistance (AMR) is a significant global health challenge, particularly impacting tropical regions.
  • International travel poses a risk for travelers to acquire multidrug-resistant (MDR) bacteria, leading to potential colonization and infection.
  • MDR Enterobacteriaceae colonization can affect up to 80% of travelers, with specific resistant strains like methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) often linked to healthcare exposures.

Purpose of the Study:

  • To highlight the risks of MDR bacterial colonization and infection in travelers returning from tropical regions.
  • To identify key risk factors associated with acquiring MDR bacteria during international travel.
  • To inform healthcare practitioners about the importance of considering MDR bacteria in patients presenting after travel.

Main Methods:

  • Review of existing literature and epidemiological data on antimicrobial resistance and travel medicine.
  • Analysis of risk factors for colonization with MDR Enterobacteriaceae, MRSA, and VRE in travelers.
  • Discussion of diagnostic approaches, including stool screening and mucocutaneous swabs.

Main Results:

  • Travel to tropical regions is associated with an increased risk of colonization by MDR bacteria.
  • Key risk factors for MDR Enterobacteriaceae colonization include the specific region visited, experiencing diarrhea, and antibiotic use.
  • Healthcare system contact in the visited country is a significant factor for MRSA and VRE colonization.

Conclusions:

  • Healthcare providers must consider the possibility of MDR bacterial infections in patients returning from travel abroad.
  • Screening for MDR bacteria through stool or mucocutaneous swabs may be warranted in specific clinical situations for returning travelers.
  • Raising awareness among travelers and healthcare professionals about AMR risks associated with international travel is crucial.

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