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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

Author

Listed:
  • Daloha Rodríguez-Molina

    (Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336 Munich, Germany
    Institute for Medical Information Processing, Biometry and Epidemiology—IBE, LMU Munich, 81377 Munich, Germany
    Pettenkofer School of Public Health, 81377 Munich, Germany
    Current address: Occupational and Environmental Epidemiology and NetTeaching Unit, Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 5, 80336 Munich, Germany.)

  • Fanny Berglund

    (Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
    Centre for Antibiotic Resistance Research (CARe), 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
    Centre for Antibiotic Resistance Research (CARe), 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
    Earth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, 030018 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
    Earth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, 030018 Bucharest, Romania)

  • Marcela Popa

    (Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest and the Academy of Romanian Scientists, 050657 Bucharest, Romania
    Earth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, 030018 Bucharest, Romania)

  • Beate Spießberger

    (German Centre for Infection Research (DZIF), Partner Site Munich, 80336 Munich, Germany
    Max von Pettenkofer Institute, Faculty of Medicine, LMU Munich, 81377 Munich, Germany
    Department of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, 80802 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
    Earth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, 030018 Bucharest, Romania)

  • D. G. Joakim Larsson

    (Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
    Centre for Antibiotic Resistance Research (CARe), University of Gothenburg, 40530 Gothenburg, Sweden)

  • Dennis Nowak

    (Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336 Munich, Germany
    Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), 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
    Max von Pettenkofer Institute, Faculty of Medicine, LMU Munich, 81377 Munich, Germany
    Department of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, 80802 Munich, Germany)

  • Heike Schmitt

    (Centre of Infectious Disease Control, National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands)

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.

Suggested Citation

  • Daloha Rodríguez-Molina & Fanny Berglund & Hetty Blaak & Carl-Fredrik Flach & Merel Kemper & Luminita Marutescu & Gratiela Pircalabioru Gradisteanu & Marcela Popa & Beate Spießberger & Laura Wengenrot, 2022. "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," IJERPH, MDPI, vol. 19(8), pages 1-19, April.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:8:p:4758-:d:793899
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