International Travel as a Risk Factor for Carriage of Extended-Spectrum β-Lactamase-Producing Escherichia coli in a Large Sample of European Individuals—The AWARE Study

Daloha Rodríguez-Molina, Fanny Berglund, Hetty Blaak, Carl-Fredrik Flach, Merel Kemper, Luminita Marutescu, Gratiela Pircalabioru Gradisteanu, Marcela Popa, Beate Spießberger, Laura Wengenroth, Mariana Carmen Chifiriuc, D. G. Joakim Larsson, Dennis Nowak, Katja Radon, Ana Maria de Roda Husman, Andreas Wieser and Heike Schmitt
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Daloha Rodríguez-Molina: Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336 Munich, Germany
Fanny Berglund: Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
Hetty Blaak: Centre of Infectious Disease Control, National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands
Carl-Fredrik Flach: Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
Merel Kemper: Centre of Infectious Disease Control, National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands
Luminita Marutescu: Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest and the Academy of Romanian Scientists, 050657 Bucharest, Romania
Gratiela Pircalabioru Gradisteanu: Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest and the Academy of Romanian Scientists, 050657 Bucharest, Romania
Marcela Popa: Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest and the Academy of Romanian Scientists, 050657 Bucharest, Romania
Beate Spießberger: German Centre for Infection Research (DZIF), Partner Site Munich, 80336 Munich, Germany
Laura Wengenroth: Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336 Munich, Germany
Mariana Carmen Chifiriuc: Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest and the Academy of Romanian Scientists, 050657 Bucharest, Romania
D. G. Joakim Larsson: Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
Dennis Nowak: Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336 Munich, Germany
Katja Radon: Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336 Munich, Germany
Ana Maria de Roda Husman: Centre of Infectious Disease Control, National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands
Andreas Wieser: German Centre for Infection Research (DZIF), Partner Site Munich, 80336 Munich, Germany
Heike Schmitt: Centre of Infectious Disease Control, National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands

IJERPH, 2022, vol. 19, issue 8, 1-19

Abstract: Antibiotic resistance (AR) is currently a major threat to global health, calling for a One Health approach to be properly understood, monitored, tackled, and managed. Potential risk factors for AR are often studied in specific high-risk populations, but are still poorly understood in the general population. Our aim was to explore, describe, and characterize potential risk factors for carriage of Extended-Spectrum Beta-Lactamase-resistant Escherichia coli (ESBL-EC) in a large sample of European individuals aged between 16 and 67 years recruited from the general population in Southern Germany, the Netherlands, and Romania. Questionnaire and stool sample collection for this cross-sectional study took place from September 2018 to March 2020. Selected cultures of participants’ stool samples were analyzed for detection of ESBL-EC. A total of 1183 participants were included in the analyses: 333 from Germany, 689 from the Netherlands, and 161 from Romania. Travels to Northern Africa (adjusted Odds Ratio, aOR 4.03, 95% Confidence Interval, CI 1.67–9.68), Sub-Saharan Africa (aOR 4.60, 95% CI 1.60–13.26), and Asia (aOR 4.08, 95% CI 1.97–8.43) were identified as independent risk factors for carriage of ESBL-EC. Therefore, travel to these regions should continue to be routinely asked about by clinical practitioners as possible risk factors when considering antibiotic therapy.

Keywords: antibiotic resistance; antimicrobial resistance; risk factors; ESBL E. coli; travels (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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