Volume 20, Number 4—April 2014
Research
High Rates of Antimicrobial Drug Resistance Gene Acquisition after International Travel, the Netherlands
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.