A passage from India: Association between air traffic and reported cases of New Delhi Metallo-beta-lactamase 1 from 2007 to 2012. Issue 4 (July 2015)

• Record Type: Journal Article
• Authors: MacFadden, Derek R.; Bogoch, Isaac I.; Brownstein, John S.; Daneman, Nick; Fisman, David; German, Matthew; Khan, Kamran
• Is Part Of: Travel medicine and infectious disease. Volume 13:Issue 4(2015)
• Page Start: 295
• Page End: 299
• Publication Date: 2015-07
• Subjects: Travel -- Health aspects -- Periodicals; Communicable diseases -- Periodicals; Tropical medicine -- Periodicals; 610.5
• DOI: 10.1016/j.tmaid.2015.06.003
• Languages: English
• ISSNs: 1477-8939

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Summary</title> <sec> <title id="sectitle0015">Background</title> <p id="abspara0010">Highly transmissible genes encoding resistance to carbapenems have demonstrated global spread. The New Delhi Metallo-beta-lactamase 1 gene is hypothesized to have originated in India, with subsequent dissemination by colonized or infected travelers.</p> </sec> <sec> <title id="sectitle0020">Method</title> <p id="abspara0015">We conducted an ecological study evaluating the association between the cumulative air traffic departing India between 2007 and 2012 and published cases of NDM-1. Receiver operator characteristic curves were generated as well as multivariate logistic regression models. 193 countries with complete flight and World Bank data were included in the analysis.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">Receiver operator characteristic curves (ROC) of the dichotomous outcome of a published case of NDM-1 were generated, yielding an unadjusted area under the curve (AUC) of 0.88 and adjusted AUC of 0.85. The unadjusted odds ratio of having a reported case of NDM-1, for every percentage increase in cumulative air traffic departing India, was 2.3 (95% CI 1.4 to 3.7) and adjusted was 2.0 (95% CI 1.2 to 3.4).</p> </sec> <sec> <title id="sectitle0030">Conclusions</title> <p id="abspara0025">We demonstrate that flows of international travelers departing India by air is associated with published NDM-1 cases, globally. Countries with high passenger flight traffic from India with no reported cases of NDM-1 may be at increased risk of having unreported transmission of NDM-1.</p> </sec> </abstract>