Colonisation with Escherichia coli resistant to "critically important" antibiotics: a high risk for international travellers
Colonisation with Escherichia coli resistant to "critically important" antibiotics: a high risk for international travellers
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DOI：
10.1007/s10096-010-1031-y
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发表时间：
2010-12-01
影响因子：
4.5
通讯作者：
Collignon, P.
中科院分区：
文献类型：
--
作者：
Kennedy, K.;Collignon, P.
社区获得性大肠杆菌分离株的耐药性在全球范围内不断增加，国际旅行成为定植和感染的风险。目的是确定耐药大肠杆菌的定殖率和持续时间。在国际旅行后。来自澳大利亚堪培拉的102名成人医院工作人员和接触者在国际旅行前后提交了肛周/直肠拭子。拭子选择性培养鉴定E.对庆大霉素、环丙沙星和/或第三代头孢菌素耐药的大肠杆菌。耐药E.每月检测旅行后大肠杆菌的持续定植。抗虫E.大肠杆菌感染率从旅行前的7.8%（95%置信区间[CI] 3.8-14.9）显著增加到旅行后的49%（95% CI 39.5-58.6）。那些殖民者更有可能在旅行时服用抗生素;然而，旅行仍然是一种独立于抗生素使用的风险。抗性E.大肠杆菌感染最常见于前往亚洲后。而超过一半的携带耐药E.旅行后的大肠杆菌在返回两个月后没有检测到耐药菌株，至少18%在六个月内仍然存在。抗虫E.大肠杆菌通常发生在国际旅行后，并可能持续存在。医生应该意识到这种风险，特别是在管理疑似革兰氏阴性脓毒症患者时。
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.