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Acquisition of Multidrug-Resistant Gram-Negative Organisms During Travel
Clinton K Murray1, Dana M Blyth2
1Deputy Medical Corps Chief, Medical Corps Specific Branch Proponent Office, Infectious Disease Consultant to the Army Surgeon General, Brooke Army Medical Center, JBSA Fort Sam Houston, TX 78234.
Abstract:
The rate of multidrug resistance has continued to increase worldwide, presenting clinicians with further challenges related to patient care. In this article, we review information related to the acquisition of multidrug-resistant (MDR) Gram-negative organisms among travelers, including deployed personnel, as well as the potential impact on wound microbiology and travelers' diarrhea. Travel to Asia, experiencing travelers' diarrhea, and use of antibiotics, whereas abroad have been associated with an increased risk of acquiring MDR Enterobacteriaceae colonization. Acquisition of new pathogens (MDR and non-MDR) through travel may result in microbiome changes (both gastrointestinal and nongastrointestinal), which may lead to alterations in the gastrointestinal flora and antimicrobial resistance. Although the long-term impact of MDR Enterobacteriaceae is unknown, host colonization changes may occur, which could lead to infectious outcomes. In particular, a well-recognized complication is urinary tract infections (UTIs), whereas MDR wound infections, pneumonia, and travelers' diarrhea are also potential outcomes relevant to military health.
Insights
Travel increases the risk of acquiring multidrug-resistant (MDR) Gram-negative organisms, potentially impacting gut health and leading to infections like UTIs, especially for deployed personnel.
Area of Science:
- Microbiology
- Infectious Diseases
- Travel Medicine
Background:
- Global rise in multidrug resistance (MDR) poses clinical challenges.
- Travelers, including military personnel, are at risk of acquiring MDR Gram-negative organisms.
Purpose of the Study:
- To review the acquisition of MDR Gram-negative organisms in travelers.
- To assess the impact on wound microbiology and travelers' diarrhea.
Main Methods:
- Literature review of studies on MDR organism acquisition in travelers.
- Analysis of risk factors associated with MDR Enterobacteriaceae colonization.
Main Results:
- Travel to Asia, experiencing diarrhea, and antibiotic use abroad are linked to increased MDR Enterobacteriaceae colonization.
- Acquisition of pathogens can alter gastrointestinal and non-gastrointestinal microbiomes, potentially increasing antimicrobial resistance.
Conclusions:
- Travel-associated MDR organism acquisition may lead to long-term colonization changes and infectious outcomes.
- Potential complications include urinary tract infections, wound infections, pneumonia, and travelers' diarrhea, particularly relevant to military health.
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