Travellers under the age of 30 are at higher risk of contracting or carrying antibiotic-resistant bacteria in their gut if they stay in hotels or private accommodation in low and/or middle-income countries, a European conference heard last night.
New research being presented at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) in Amsterdam, Netherlands, found that travellers who mainly stayed in a hotel or private accommodation had a four times greater risk of returning home with multi-drug resistant bacteria in their gut than those who mainly stayed in guest houses, hostels, or camping.
The authors say this study is the first to demonstrate that staying in a hotel as a risk factor for colonisation with extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE).
Co-author Dr Lynn Meurs from the Robert Koch-Institute, Berlin, Germany, said: “Previous studies had already reported this for staying in a private accommodation, but it was unexpected that hotel might also be a risk factor.
“Colonisation in itself does not lead to any health problems. However, there is a risk of infection with bacteria that patients are colonised with, especially in hospitalised patients. Should that occur with extended-spectrum beta-lactamase producing Enterobacteriaceae, these infections such as urinary tract infections, pneumonia, and sepsis, may be more difficult to treat than infections with bacteria that are susceptible to standard antibiotics.”
Dr Meurs and colleagues from a joint project of the Leipzig University Hospital and the Robert Koch Institute in Berlin, Germany, studied risk factors for intestinal ESBL-PE colonisation in 230 people who attended a travel clinic at the Leipzig University Hospital, Germany, before travelling between March 2016 and March 2017.
The researchers collected stool samples from participants before and after they travelled outside Germany. All travellers completed questionnaires on risk factors including the countries they visited, length of time in country, type of residence, symptoms, antibiotic treatment, healthcare use, diet, and hygiene.
Results showed that 53 (23%) contracted ESBL-producing bacteria during their trip abroad, with those travelling to either Western, Southern or Eastern Asia, facing the highest risk of contracting the resistant bacteria.
Those staying in a hotel or in private accommodation were four times more likely to contract ESBL-producing bacteria than those staying in a residence like a hostel, guest house or camping, and travellers aged 20-30 years were five times more likely to contract drug-resistant bacteria compared to travellers aged 50 years and over.
“Many people visit low- and middle-income countries in tropical and semi-tropical regions every year. With around 20% of travellers returning positive for these resistant bacteria, our findings reconfirm that intercontinental travel, especially to already known high risk areas, likely contributes to their global spread,” said Dr Meurs.
“We therefore recommend raising awareness in returning (high-risk) travellers. They should know that 1) they may be carrying drug resistant bacteria in the weeks after travel and 2) how they can effectively prevent the spread to other persons, for example through adequate hand hygiene.”
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