Prevalence and Risk Factors for Colonization by Multidrug-Resistant Microorganisms among Long-Term Travelers and Recently Arrived Migrants

Author:

Monsálvez Víctor1ORCID,Bierge Paula23ORCID,Machado María Luisa1ORCID,Pich Oscar Q.23ORCID,Nuez-Zaragoza Elisa4,Roca Carme56,Jiménez-Lozano Ana I.7,Martínez-Perez Ángela89ORCID,Gomila-Grange Aina1ORCID,Vera-Garcia Isabel10,Requena-Méndez Ana8111213ORCID,Capilla Silvia414ORCID,Gasch Oriol115ORCID

Affiliation:

1. Infectious Diseases Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, 08208 Sabadell, Spain

2. Laboratori de Recerca en Microbiologia i Malalties Infeccioses, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, 08208 Sabadell, Spain

3. Institut de Biotecnologia i Biomedicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain

4. Microbiology Unit, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, 08208 Sabadell, Spain

5. Centre d’Atenció Primaria El Clot, Institut Català de la Salut (ICS), Carrer Concilio de Trento 25, 08018 Barcelona, Spain

6. Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Carrer Casanova, 143, 08036 Barcelona, Spain

7. Centre d’Atenció Primaria Roger, Badal 3I Institut Catala de la Salut ICS Barcelona, 08028 Barcelona, Spain

8. Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, Universitat de Barcelona, Carrer Roselló 132, 08036 Barcelona, Spain

9. Centre d’Atenció Primaria Casanova, Consorci d’Atenció Primària de Salut de l’Eixample (CAPSBE) Casanova, Carrer Rosselló 161, 08036 Barcelona, Spain

10. Tropical Diseases, International Health and International Traveler Attention Unit, Clinic Hospital of Barcelona, 08036 Barcelona, Spain

11. Biomedical Research Networking Center (CIBER) of Infectious Diseases, Carlos III Health Institute (CIBERINFEC, ISCIII), Carrer Melchor Fernández Almagro, 3, 28029 Madrid, Spain

12. Department of Medicine Solna, Karolinska Institutet, Solnavägen 1, 17177 Solna-Stockholm, Sweden

13. Department of Infectious Diseases, Karolinska University Hospital, Solnavägen 1, 17177 Solna-Stockholm, Sweden

14. Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain

15. Department of Medicine, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain

Abstract

Multidrug-resistant (MDR) bacteria have become one of the most important health problems. We aimed to assess whether international travel may facilitate their spread through the colonization of asymptomatic travelers. A cross-sectional study was conducted (November 2018 to February 2022). Pharyngeal and rectal swabs were obtained from long-term travelers and recently arrived migrants from non-European countries, and an epidemiological survey was performed. Colonization by Gram-negative bacteria and methicillin-resistant Staphylococcus aureus (MRSA) was determined by chromogenic media and MALDI-TOF-MS. Resistance mechanisms were determined by the biochip-based molecular biology technique. Risk factors for colonization were assessed by logistic regression. In total, 122 participants were included: 59 (48.4%) recently arrived migrants and 63 (51.6%) long-term travelers. After their trip, 14 (11.5%) participants—5 (8.5%) migrants and 9 (14.3%) travelers—had rectal colonization by one MDR bacterium. Escherichia coli carrying the extended-spectrum beta-lactamase (ESBL) CTX-M-15 was the most frequent. No participants were colonized by MRSA or carbapenemase-producing Enterobacteriaceae. The only risk factor independently associated with MDR bacterial colonization was previous hospital attention [OR, 95% CI: 10.16 (2.06–50.06)]. The risk of colonization by MDR bacteria among recently arrived migrants and long-term travelers is similar in both groups and independently associated with previous hospital attention.

Funder

Fondo Europeo de Desarrollo Regional

Publisher

MDPI AG

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3. European Centre for Disease Prevention and Control and WHO Regional Office for Europe (2023, February 26). Surveillance of Antimicrobial Resistance in Europe, 2021 Data. Executive Summary. Stockholm: European Centre for Disease Prevention and Control; 2022. Available online: https://www.ecdc.europa.eu/en/publications-data/surveillance-antimicrobial-resistance-europe-2021-data.

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