Impact of international travel and diarrhea on gut microbiome and resistome dynamics

Manish Boolchandani, Kevin S. Blake, Drake H. Tilley, Miguel M. Cabada, Drew J. Schwartz, Sanket Patel, Maria Luisa Morales, Rina Meza, Giselle Soto, Sandra D. Isidean, Chad K. Porter, Mark P. Simons () and Gautam Dantas ()
Additional contact information
Manish Boolchandani: Washington University School of Medicine
Kevin S. Blake: Washington University School of Medicine
Drake H. Tilley: Naval Medical Research Unit No. 6, Callao
Miguel M. Cabada: University of Texas Medical Branch
Drew J. Schwartz: Washington University School of Medicine
Sanket Patel: Washington University School of Medicine
Maria Luisa Morales: Universidad Peruana Cayetano Heredia
Rina Meza: Naval Medical Research Unit No. 6, Callao
Giselle Soto: Naval Medical Research Unit No. 6, Callao
Sandra D. Isidean: Naval Medical Research Center
Chad K. Porter: Naval Medical Research Center
Mark P. Simons: Naval Medical Research Unit No. 6, Callao
Gautam Dantas: Washington University School of Medicine

Nature Communications, 2022, vol. 13, issue 1, 1-19

Abstract: Abstract International travel contributes to the global spread of antimicrobial resistance. Travelers’ diarrhea exacerbates the risk of acquiring multidrug-resistant organisms and can lead to persistent gastrointestinal disturbance post-travel. However, little is known about the impact of diarrhea on travelers’ gut microbiomes, and the dynamics of these changes throughout travel. Here, we assembled a cohort of 159 international students visiting the Andean city of Cusco, Peru and applied next-generation sequencing techniques to 718 longitudinally-collected stool samples. We find that gut microbiome composition changed significantly throughout travel, but taxonomic diversity remained stable. However, diarrhea disrupted this stability and resulted in an increased abundance of antimicrobial resistance genes that can remain high for weeks. We also identified taxa differentially abundant between diarrheal and non-diarrheal samples, which were used to develop a classification model that distinguishes between these disease states. Additionally, we sequenced the genomes of 212 diarrheagenic Escherichia coli isolates and found those from travelers who experienced diarrhea encoded more antimicrobial resistance genes than those who did not. In this work, we find the gut microbiomes of international travelers’ are resilient to dysbiosis; however, they are also susceptible to colonization by multidrug-resistant bacteria, a risk that is more pronounced in travelers with diarrhea.

Date: 2022
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DOI: 10.1038/s41467-022-34862-w

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