Volume 20, Number 4—April 2014
Research
High Rates of Antimicrobial Drug Resistance Gene Acquisition after International Travel, the Netherlands
Christian J.H. von Wintersdorff, John Penders, Ellen E. Stobberingh, Astrid M.L. Oude Lashof, Christian J.P.A. Hoebe, Paul H.M. Savelkoul, and Petra F.G. Wolffs
Table 3
Associations between travel-associated risk factors and rates of blaCTX-M, qnrB, and qnrS acquisition among 122 healthy travelers from the Netherlands, 2010–2012*
| Traveler characteristic |
No. travelers |
Antimicrobial drug resistance genes acquired by travelers | |||||||
| blaCTX-M |
qnrB |
qnrS |
|||||||
| No. (%) |
OR (95% CI)‡ |
No. (%) |
OR (95% CI)‡ |
No. (%) |
OR (95% CI)‡ |
||||
| Region visited | |||||||||
| Europe and America§¶ | 16† | 1 (6.3) | 1.00 | 6 (37.5) | 1.00 | 3 (18.8) | 1.00 | ||
| Southeast Asia | 28† | 5 (17.9) | 3.34 (0.34–33.14) | 7 (25.0) | 0.47 (0.12–1.90) | 21 (75.0) | 15.74 (3.13–79.24) | ||
| Indian subcontinent | 31† | 18 (58.1) | 26.22 (2.86–240.18) | 10 (32.3) | 0.71 (0.18–2.71) | 19 (61.3) | 9.23 (1.94–43.87) | ||
| Northern Africa | 16† | 5 (31.3) | 7.28 (0.70–75.92) | 5 (31.3) | 0.64 (0.14–2.98) | 7 (43.8) | 2.90 (0.54–15.57) | ||
| Southern Africa |
17† |
5 (29.4) |
5.57
(0.56–55.77) |
5 (29.4) |
0.65 (0.15–2.84) |
6 (35.3) |
2.41 (0.46–12.66) |
||
| Sex | |||||||||
| F§ | 71 | 25 (35.2) | 1.00 | 25 (35.2) | 1.00 | 41 (57.7) | 1.00 | ||
| M |
51 |
13 (25.5) |
0.62 (0.23–1.67) |
15 (29.4) |
1.06 (0.44–2.57) |
21 (41.2) |
0.39 (0.15–1.00) |
||
| Antimicrobial drug use | |||||||||
| No§ | 107 | 32 (29.9) | 1.00 | 35 (32.7) | 1.00 | 52 (48.6) | 1.00 | ||
| Yes |
15 |
6 (40.0) |
1.44 (0.40–5.25) |
5 (33.3) |
1.28 (0.36–4.51) |
10 (66.7) |
1.64 (0.43–6.22) |
||
| Traveler’s diarrhea | |||||||||
| No§ | 77 | 20 (26.0) | 1.00 | 25 (32.5) | 1.00 | 40 (51.9) | 1.00 | ||
| Yes |
45 |
18 (40.0) |
1.84 (0.70–4.82) |
15 (33.3) |
0.97 (0.40–2.37) |
22 (48.9) |
0.65 (0.26–1.63) |
||
| *OR, odds ratio. Boldface indicates statistical significance (p<0.05). †Numbers do not total 122 because the 14 travelers who visited multiple or unknown regions were added to a remainder category not included in this table. ‡ORs and 95% CIs of the associations between risk factor and acquisition of resistance gene (negative before travel and positive after travel) by multivariable logistic regression analysis. Models included the following variables: travel destination, age, travel duration, sex, and antimicrobial drug use within 3 mo. preceding the travel, and traveler’s diarrhea. §Reference category. ¶Southern Europe, Central and South America, previously reported non–high-risk regions, were pooled to establish an adequately sized reference category. | |||||||||
*These authors contributed equally to this article and are co–first authors.
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