Acquisition of antimicrobial resistance determinants in Enterobacterales by international travelers from a large urban setting in Brazil

dc.creatorTufic-Garutti, Samantha dos Santos
dc.creatorRamalho, João Vitor Almeida Ramalho
dc.creatorLongo, Luís Guilherme de Araújo
dc.creatorOliveira, Gabriela Caramano de
dc.creatorRocha, Gabriel Taddeucci
dc.creatorVilar, Lucas Cecílio
dc.creatorCosta, Marcellus Dias da
dc.creatorPicão, Renata Cristina
dc.creatorGirão, Valéria Brígido de Carvalho
dc.creatorSantoro-Lopes, Guilherme
dc.creatorMoreira, Beatriz Meurer
dc.creatorRodrigues, Káris Maria de Pinho
dc.date2021-12-29T13:40:22Z
dc.date2021-12-29T13:40:22Z
dc.date2021
dc.date.accessioned2023-09-26T21:35:49Z
dc.date.available2023-09-26T21:35:49Z
dc.identifierTUFIC-GARUTTI, Samantha dos Santos et al. Acquisition of antimicrobial resistance determinants in Enterobacterales by international travelers from a large urban setting in Brazil. Travel Medicine and Infectious Disease, v. 41, p. 1-9, 2021
dc.identifier1477-8939
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/50556
dc.identifier10.1016/j.tmaid.2021.102028
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8872940
dc.descriptionBackground: Antimicrobial resistance is increased by international mobility. We present data about intestinal colonization of travelers departing from a middle-income country. Methods: Travelers were recruited from 2015 to 2019, collected an anal stool specimen and answered a questionnaire before and after travel. Enterobacterales isolates were investigated for antimicrobial resistance; extended-spectrum beta-lactamase (ESBL) and carbapenemase production; plasmid-encoded cephalosporinases (pAmpC), plasmid-mediated quinolone resistance (PMQR) and mcr genes by PCR and sequencing; and association with travel related variables. Results: Among 210 travelers, 26 (12%) carried multidrug-resistant Enterobacterales (MDR-E) and 18 (9%) ESBLproducing Enterobacterales (ESBL-E) before travel, with an increased prevalence from 1% to 11% over the study years. Acquisition of MDR-E and ESBL-E occurred in 59 (32%) and 43 (22%) travelers, respectively, mostly blaCTX-M-15 carrying Escherichia coli. One traveler acquired one isolate carrying blaOXA-181 gene, and two others, isolates carrying mcr-1. PMQR were detected in 14 isolates of returning travelers. The risk of MDR-E acquisition was higher in Southeast Asia and the Indian subcontinent, and after using antimicrobial agents. Conclusion: We describe an increasing pre-travel prevalence of ESBL-E colonization in subjects departing from this middle-income country over time. Travel to known risk areas and use of antimicrobial agents during travel were associated with acquisition of MDR-E. Travel advice is critical to mitigating this risk, as colonization by MDR-E may raise the chances of antimicrobial-resistant infections.
dc.formatapplication/pdf
dc.languageeng
dc.publisherElsevier
dc.rightsrestricted access
dc.subjectMultidrug-resistant Enterobacterales acquisition
dc.subjectESBL-E acquisition
dc.subjectTravel
dc.subjectColonization
dc.titleAcquisition of antimicrobial resistance determinants in Enterobacterales by international travelers from a large urban setting in Brazil
dc.typeArticle


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