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The stay in a hotel or private accommodation is badociated with
contracting and transporting drug-resistant bacteria at home among travelers
low-income and middle-income countries, according to a new study
presented at the European Congress of Clinical Studies this year
Microbiology and Infectious Diseases (ECCMID) in Amsterdam,
Netherlands (April 13-16). Young travelers aged 20 to 30 were also
present an increased risk compared to other age groups.
This study of 230 people from Germany to low-income and middle-income countries found that
travelers who were staying mainly in a hotel or private accommodation
risk four times higher in each case of returning home with multiple medications
resistant bacteria in their gut than those who stayed mainly in others
types of tourist accommodation such as guest houses, youth hostels or camping.
According to the authors, the study is the first to report staying in an institution
hotel as a risk factor for extended spectrum colonization
Enterobacteria producing beta-lactamases (PEBSE-PE), which are
resistant to several antibiotics.
"Previous studies had already reported this to stay in a private
accommodation but it was unexpected that this hotel could also be a risk
Lynn Meurs of Robert Koch-Institute, co-author
Berlin, Germany. "Colonization itself does not cause any health problems.
problems. However, there is a risk of infection by bacteria that
patients are colonized with, especially in hospitalized patients. should
that occur with extended-spectrum beta-lactamase production
Enterobacteriaceae, these infections such as urinary tract infections,
pneumonia and sepsis may be more difficult to treat than infections
with bacteria that are sensitive to conventional antibiotics. "
The purpose of the study is not to examine the effects of a hotel
remain on the colonization BLSE-EP, additional studies are needed to evaluate
if the surprising combination between stay at the hotel and
ESBL colonization is well reproducible, and to better evaluate
Factors can cause such an badociation, say the researchers.
Study the impact of intercontinental travel on the spread
ESBL producing bacteria, Meurs and colleagues of a joint project of
the University Hospital Leipzig and the Robert Koch Institute in Berlin,
Germany, studied the risk factors for intestinal colonization of ESBL-PE in the
230 people attending a travel clinic at the Leipzig University Hospital,
Germany, before traveling between March 2016 and March 2017.
Researchers collected stool samples for testing with
participants before and after their trip outside Germany. All
travelers completed questionnaires on risk factors, including
countries visited, length of stay in the country, type of residence,
symptoms, antibiotic treatment, use of health care, diet and hygiene.
Modeling has been used to identify risk factors badociated with travel.
Colonization by the ESBL-PE. Seven travelers tested positive for ESBLs
before the trip were excluded from the badyzes.
The results showed that about 1 in 23 (23%; 53/230) travelers had contracted ESBL-producing bacteria while traveling abroad.
People traveling to West, South or East Asia faced
the highest risk of contracting the resistant bacteria – they had four
times more risk of being colonized by ESBL-producing bacteria than
those who visited other LMICs in the tropics and subtropics.
The data also showed that people staying in a hotel or
private dwellings were in each case four times as likely to
to contract ESBL-producing bacteria than those staying in a residence, such as a
hostel, guest house or campsite.
The risk of colonization by ESBLs also varied with age, with
travelers aged 20 to 30 at a five times greater probability of
to contract drug-resistant bacteria compared to 50-year-old travelers
and more. The authors suggest that it is probably because the elderly
In this study, 20 to 30 years have traveled longer than other travelers
age categories. As such, they may have been exposed longer to ESBLs.
and therefore have a higher risk of returning home colonized.
"Many people visit low- and middle-income countries in the tropics and
semi-tropical regions each year. With about 20% of travelers
returning positive for these resistant bacteria, our results reconfirm
intercontinental travel, especially those already known to be at high risk
probably contributes to their spread on a global scale, "says Dr Meurs.
"We therefore recommend raising people's awareness of the return (high risk)
The travellers. They must know that 1) they can carry resistant drugs
bacteria in the weeks following the trip and 2) how they can effectively
prevent spread to other people, for example by adequate means
hygiene."
This observational study in a travel clinic can not prove that the
the type of accommodation causes colonization by ESBL producing bacteria,
but only suggests the possibility of such an effect. The authors emphasize
to several limitations, including the fact that the study was not sufficiently
powered to detect other risk factors or protection related to travel
The acquisition of BLSE-PE, and that travelers attending a travel clinic can:
not be representative of all people traveling in the tropics.
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