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Tourism leads to the worldwide spread of multidrug-resistant pathogens
The global spread of multidrug-resistant pathogens is a massive problem in medicine. A recent study concludes that tourism plays a key role in the spread of resistant bacteria. "A large proportion of travelers visiting a low-standard country bring multi-drug intestinal germs to their homeland," the CRM Center for Travel Medicine reports on the study results.
The Dutch research team around Dr. med. John Penders from the University Medical Center in Maastricht has investigated the spread of multidrug-resistant bacteria in the course of global tourism and has come to a worrying conclusion: Many travelers haul in pathogens and spread them among the local population. Thus, global tourism has a significant influence on the spread of multidrug-resistant bacteria. The results of the study were published in the journal "The Lancet Infectious Diseases".
Underestimated risk: International travel has a significant impact on the spread of multiresistant pathogens. (Image: NicoElNino / fotolia.com) Spread of ESBL-forming bacteria
"International travel contributes to the spread of antimicrobial resistance," explain the researchers. For their study, they investigated the spread of so-called "extensively β-lactamase-producing Enterobacteriaceae" (ESBL-E). The ESBL-producing bacteria are resistant to many antibiotics and therefore infections are often difficult to treat. A total of 2001 Dutch travelers and 215 non-traveling household members were screened in the current study on faecal samples and questionnaires on demographics, disease and behavior - both before travel, immediately after return, and one, three, six and 12 months later.
Particularly high risk when traveling to Southeast Asia
The results of the researchers were terrifying. "Of the 1,847 travelers who were ESBL negative before the trip and provided samples after return, 633 (34.3 percent) had acquired ESBL-E during the international voyage," Penders and colleagues. Among travelers to South Asia, even 136 out of 181 subjects were carriers of bacteria after the trip (more than 75 percent). Essential indications for the risk of ESBL-E intake are the use of antibiotics during travel, traveler's diarrhea and pre-existing chronic intestinal diseases, the researchers explain.
Often household members are infected
On average, colonization with the bacteria persisted 30 days after travel, but 577 subjects remained colonized after 12 months. The researchers were also able to prove in 13 cases a transmission of the pathogens to household members. "The probability of transferring ESBL-E to another household member was 12%," the researchers write. However, the ESBL-forming bacteria "do not have to make you sick per se," explains the CRM. "For many carriers, these germs never become a problem - it is even normal to a certain extent that we all carry multi-drug resistant bacteria in us," said Professor. med. Tomas Jelinek, Scientific Director of CRM.
Risks due to multi-resistant pathogens
According to Prof. Jelinek, in people with a weakened immune system, chronic illness or recent surgery, the multidrug-resistant pathogens can become "a massive problem." Various forms of infection are possible, which are then difficult to treat because of the resistance of the germ. "We need more awareness from both physicians and travelers about the problem of long-distance travel and multidrug-resistant pathogens that are spread throughout the country," says Jelinek.
Education about the risk required for international travel
According to the experts, international travelers should pay particular attention to hygiene during and after their journey. For example, most germs would be transmitted by hands. Here, regular and thorough hand washing can protect endangered people in the environment to a certain extent, explains Jelinek. If a visit to a doctor or clinic is required after the trip, "Travelers should proactively inform the doctors that and when they were abroad," the CRM continues. But doctors are also in demand, says Prof. Jelinek. On the one hand in the information of travelers on risk factors, on the other hand in the consideration of possible imported resistances by travelers.
The doctors are required
The Dutch scientists conclude that the spread of ESBL-E during and after international travel is worrying. Travelers to high-risk areas of ESBL-E acquisition should therefore be considered as potential carriers of ESBL-E for up to 12 months after return. Penders and colleagues. Corresponding infections "must be considered more in the treatment of travelers themselves, as well as a potential danger to other patients - such as hospital stays -" says Prof. Jelinek in the press release of the CRM. (Fp)