Blog
About

3
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: not found
      • Article: not found

      Colonisation with Escherichia coli resistant to “critically important” antibiotics: a high risk for international travellers

      Read this article at

      ScienceOpenPublisherPubMed
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Antimicrobial resistance among community-acquired isolates of Escherichia coli is increasing globally, with international travel emerging as a risk for colonisation and infection. The aim was to determine the rate and duration of colonisation with resistant E. coli following international travel. One hundred and two adult hospital staff and contacts from Canberra, Australia, submitted perianal/rectal swabs before and following international travel. Swabs were cultured selectively to identify E. coli resistant to gentamicin, ciprofloxacin and/or third-generation cephalosporins. Those with resistant E. coli post-travel were tested monthly for persistent colonisation. Colonisation with antibiotic-resistant E. coli increased significantly from 7.8% (95% confidence interval [CI] 3.8-14.9) pre-travel to 49% (95% CI 39.5-58.6) post-travel. Those colonised were more likely to have taken antibiotics whilst travelling; however, travel remained a risk independent of antibiotic use. Colonisation with resistant E. coli occurred most frequently following travel to Asia. While over half of those carrying resistant E. coli post-travel had no detectable resistant strains two months after their return, at least 18% remained colonised at six months. Colonisation with antibiotic-resistant E. coli occurs commonly after international travel, and can be persistent. Medical practitioners should be aware of this risk, particularly when managing patients with suspected Gram-negative sepsis.

          Related collections

          Most cited references 20

          • Record: found
          • Abstract: not found
          • Article: not found

          Detection of Plasmid-Mediated AmpC  -Lactamase Genes in Clinical Isolates by Using Multiplex PCR

            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Molecular epidemiology of Escherichia coli producing CTX-M beta-lactamases: the worldwide emergence of clone ST131 O25:H4.

            Since 2000, Escherichia coli producing CTX-M enzymes have emerged worldwide as important causes of community-onset urinary tract and bloodstream infections owing to extended-spectrum beta-lactamase (ESBL)-producing bacteria. Molecular epidemiological studies suggested that the sudden worldwide increase of CTX-M-15-producing E. coli was mainly due to a single clone (ST131) and that foreign travel to high-risk areas, such as the Indian subcontinent, might in part play a role in the spread of this clone across different continents. Empirical antibiotic coverage for these resistant organisms should be considered in community patients presenting with sepsis involving the urinary tract, especially if the patient recently travelled to a high-risk area. If this emerging public health threat is ignored, it is possible that the medical community may be forced, in the near future, to use carbapenems as the first choice for the empirical treatment of serious infections associated with urinary tract infections originating from the community. (c) 2009 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              World Health Organization ranking of antimicrobials according to their importance in human medicine: A critical step for developing risk management strategies for the use of antimicrobials in food production animals.

              The use of antimicrobials in food animals creates an important source of antimicrobial-resistant bacteria that can spread to humans through the food supply. Improved management of the use of antimicrobials in food animals, particularly reducing the usage of those that are "critically important" for human medicine, is an important step toward preserving the benefits of antimicrobials for people. The World Health Organization has developed and applied criteria to rank antimicrobials according to their relative importance in human medicine. Clinicians, regulatory agencies, policy makers, and other stakeholders can use this ranking when developing risk management strategies for the use of antimicrobials in food production animals. The ranking allows stakeholders to focus risk management efforts on drugs used in food animals that are the most important to human medicine and, thus, need to be addressed most urgently, such as fluoroquinolones, macrolides, and third- and fourth-generation cephalosporins.
                Bookmark

                Author and article information

                Journal
                European Journal of Clinical Microbiology & Infectious Diseases
                Eur J Clin Microbiol Infect Dis
                Springer Science and Business Media LLC
                0934-9723
                1435-4373
                December 2010
                September 12 2010
                December 2010
                : 29
                : 12
                : 1501-1506
                Article
                10.1007/s10096-010-1031-y
                20835879
                © 2010

                Comments

                Comment on this article