Prolonged carriage of resistant E-coli by returned travellers: clonality, risk factors and bacterial characteristics

Rogers, B. A., Kennedy, K. J., Sidjabat, H. E., Jones, M., Collignon, P. and Paterson, D. L. (2012) Prolonged carriage of resistant E-coli by returned travellers: clonality, risk factors and bacterial characteristics. European Journal of Clinical Microbiology and Infectious Diseases, 31 9: 2413-2420. doi:10.1007/s10096-012-1584-z


Author Rogers, B. A.
Kennedy, K. J.
Sidjabat, H. E.
Jones, M.
Collignon, P.
Paterson, D. L.
Title Prolonged carriage of resistant E-coli by returned travellers: clonality, risk factors and bacterial characteristics
Journal name European Journal of Clinical Microbiology and Infectious Diseases   Check publisher's open access policy
ISSN 0934-9723
1435-4373
Publication date 2012-09
Sub-type Article (original research)
DOI 10.1007/s10096-012-1584-z
Volume 31
Issue 9
Start page 2413
End page 2420
Total pages 8
Place of publication Heidelberg, Germany
Publisher Springer
Collection year 2013
Language eng
Formatted abstract
The aim of this study was to delineate the potential risks and dynamics of the prolonged carriage of resistant E. coli in returned travellers. A sample of 274 previously collected E. coli resistant to ceftriaxone (CRO), ciprofloxacin, gentamicin and/or nalidixic acid recovered from 102 travellers was studied. Travellers were assessed pre-travel then longitudinally (maximum 6 months) with peri-rectal/rectal swabs. Clonality was determined by REP-PCR and the presence of O25b-ST131 was assessed. Comparison was made longitudinally for individuals and between identified co-travellers. The risk of prolonged carriage was lower for CRO than for ciprofloxacin or gentamicin resistance. Repeated isolation of the same phenotype at different time points occurred in 19% of initial CRO-resistant carriers compared with 50% of ciprofloxacin- or gentamicin-resistant carriers. The duration of carriage was also longer for the latter resistance phenotypes (75th quartile 8 vs 62 and 63 days respectively). In multivariate analysis, risks of prolonged carriage included antimicrobial use whilst travelling (3.3, 1.3–8.4) and phylogenetic group B2 (9.3, 3.4–25.6) and D (3.8, 1.6–8.8). Clonality amongst longitudinal isolates from the same participant was demonstrated in 92% of participants who were assessable and most marked amongst CRO-resistant isolates. ST-131 was surprisingly infrequent (3% of participants). Prolonged carriage of ciprofloxacin- and gentamicin-resistant isolates is more frequent and prolonged than CRO resistance after travel. Risks of prolonged carriage indicate a contribution of host and bacterial factors to this carriage. These require further elucidation. The strong clonality identified suggests that carriage of a “phenotype” was mediated by persistence of bacteria/plasmid combinations rather than persistence of the plasmid after horizontal transfer to other bacteria.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 22 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 23 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Thu, 08 Nov 2012, 13:41:17 EST by Roheen Gill on behalf of UQ Centre for Clinical Research