GeoSentinel Analysis of Travelers' Diarrhea Antimicrobial Resistance Patterns

Area of Science:

• Infectious Diseases
• Microbiology
• Global Health

Background:

• Diarrheal disease is a common cause of illness in international travelers.
• Understanding the antibiotic resistance patterns of common pathogens is essential for appropriate empiric treatment.

Purpose of the Study:

• To characterize antimicrobial nonsusceptibility patterns of major enteric pathogens causing diarrhea in international travelers.
• To identify regional variations in antimicrobial resistance.

Main Methods:

• Retrospective cross-sectional analysis of antimicrobial susceptibility data from culture-confirmed Campylobacter, Salmonella, Shigella, and diarrheagenic E. coli.
• Data collected from 58 international GeoSentinel sites between April 2015 and December 2022.
• Nonsusceptibility defined as intermediate or resistant test results.

Main Results:

• High rates of fluoroquinolone nonsusceptibility were observed in Campylobacter (75%) and NTS (32%).
• Significant regional variations in macrolide and fluoroquinolone resistance were noted, particularly in South Central Asia and South America.
• Shigella exhibited high rates of nonsusceptibility to fluoroquinolones (22%) and macrolides (35%).

Conclusions:

• Antimicrobial resistance patterns for travelers' diarrhea pathogens show considerable geographic variability.
• Obtaining antimicrobial susceptibility testing is recommended when possible to guide treatment.
• Findings can inform self-treatment and clinical management strategies for travelers' diarrhea.