Gut microbiota dynamics in travelers returning from India colonized with extended-spectrum cephalosporin-resistant Enterobacteriaceae: A longitudinal study

Travel Med Infect Dis. 2019 Jan-Feb:27:72-80. doi: 10.1016/j.tmaid.2018.10.012. Epub 2018 Oct 17.

Abstract

Background: Intestinal colonization by extended-spectrum cephalosporin-resistant Enterobacteriaceae (ESC-R-Ent) has been attributed to travel to high prevalence countries. However, the dynamics of the microbiota changes during ESC-R-Ent colonization and whether there is a particular bacterial composition which is associated with subsequent colonization is unknown.

Methods: Forty healthy volunteers living in Switzerland underwent screening before and after a trip to India, and also 3, 6 and 12 months after traveling. Culture-based ESC-R-Ent screening and microbiota analysis based on 16S rRNA amplicon sequencing were performed at all time points.

Results: Prevalence of ESC-R-Ent colonization before traveling was 10% (n = 4), whereas it increased to 76% (n = 31) after the trip. Based on bacterial diversity analyses of the gut microbiota, there were few but significant differences for colonized versus non-colonized individuals. However, an alternative, cluster based analysis revealed that individuals remained in the same cluster over time indicating that neither traveling nor ESC-R-Ent colonization significantly influences bacterial composition. Moreover, none of the found microbiota clusters were significantly associated with subsequent risk of ESC-R-Ent colonization.

Conclusion: Based on their microbiota patterns, every volunteer was at the same risk of ESC-R-Ent colonization while traveling to India. Therefore, other risk factors for ESC-R-Ent colonization are responsible for this phenomenon.

Keywords: Antimicrobial resistance; ESBL; Intestinal colonization; MDR bacteria; Microbiota; Travel.

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / pharmacology*
  • Cephalosporins / pharmacology*
  • Cluster Analysis
  • Drug Resistance, Multiple, Bacterial*
  • Enterobacteriaceae / drug effects*
  • Enterobacteriaceae / genetics
  • Enterobacteriaceae Infections / epidemiology
  • Feces / microbiology
  • Female
  • Gastrointestinal Microbiome*
  • Healthy Volunteers
  • Humans
  • India
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • RNA, Ribosomal, 16S / genetics
  • Switzerland
  • Time Factors
  • Travel-Related Illness*

Substances

  • Anti-Bacterial Agents
  • Cephalosporins
  • RNA, Ribosomal, 16S