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Impact of international travel and diarrhea on gut microbiome and resistome dynamics

Manish Boolchandani1,2, Kevin S Blake1,2, Drake H Tilley3

  • 1The Edison Family Center for Genome Sciences and Systems Biology, Washington University School of Medicine, St. Louis, MO, USA.

Nature Communications
|December 5, 2022
PubMed

Insights

International travel can alter gut microbiomes, increasing antimicrobial resistance genes, especially with travelers' diarrhea. The gut microbiome shows resilience, but diarrhea heightens the risk of multidrug-resistant bacteria colonization.

Area of Science:

  • Microbiology
  • Genomics
  • Global Health

Background:

  • International travel is a significant factor in the global dissemination of antimicrobial resistance (AMR).
  • Travelers' diarrhea increases the risk of acquiring multidrug-resistant organisms (MDROs) and can cause lasting gastrointestinal issues.
  • The impact of diarrhea on travelers' gut microbiomes and the dynamics of these changes during travel are not well understood.

Purpose of the Study:

  • To investigate the impact of international travel and diarrhea on the gut microbiome composition and antimicrobial resistance gene abundance in travelers.
  • To identify microbial taxa associated with diarrheal episodes in travelers.
  • To assess the genomic characteristics of diarrheagenic Escherichia coli in relation to traveler's diarrhea.

Main Methods:

  • Longitudinal collection and next-generation sequencing of 718 stool samples from 159 international students in Cusco, Peru.
  • Analysis of gut microbiome composition, taxonomic diversity, and antimicrobial resistance gene profiles.
  • Whole-genome sequencing of 212 diarrheagenic Escherichia coli isolates.

Main Results:

  • Gut microbiome composition changed significantly during travel, while taxonomic diversity remained stable.
  • Diarrhea led to a disruption in microbiome stability and a sustained increase in antimicrobial resistance genes.
  • A classification model was developed to distinguish diarrheal from non-diarrheal states based on microbial taxa.
  • Escherichia coli isolates from travelers with diarrhea carried more antimicrobial resistance genes compared to those without.

Conclusions:

  • The gut microbiomes of international travelers are generally resilient to dysbiosis.
  • Travelers are susceptible to colonization by multidrug-resistant bacteria, with diarrhea posing a heightened risk.
  • Understanding these dynamics is crucial for mitigating the spread of antimicrobial resistance globally.

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