Travellers returning from the island of Zanzibar colonized with MDR Escherichia coli strains: assessing the impact of local people and other sources. (1st December 2020)

• Record Type: Journal Article
• Authors: Moser, Aline I; Kuenzli, Esther; Büdel, Thomas; Campos-Madueno, Edgar I; Bernasconi, Odette J; DeCrom-Beer, Susan; Jakopp, Barbara; Mohammed, Ali Haji; Hassan, Nadir Khatib; Fehr, Jan; Zinsstag, Jakob; Hatz, Christoph; Endimiani, Andrea
• Is Part Of: Journal of antimicrobial chemotherapy. Volume 76:Number 2(2021)
• Page Start: 330
• Page End: 337
• Publication Date: 2020-12-01
• Subjects: Anti-infective agents -- Periodicals; Chemotherapy -- Periodicals; 615.58
• DOI: 10.1093/jac/dkaa457
• Languages: English
• ISSNs: 0305-7453

Abstract

Abstract: Objectives: Many travellers to low-income countries return home colonized at the intestinal level with extended-spectrum cephalosporin-resistant (ESC-R) and/or colistin-resistant (CST-R) Escherichia coli ( Ec ) strains. However, nothing is known about the local sources responsible for the transmission of these pathogens to the travellers. Methods: We compared the ESC-R- and CST-R- Ec strains found in the pre- ( n = 23) and post-trip ( n = 37) rectal swabs of 37 travellers from Switzerland to Zanzibar with those (i) contemporarily isolated from local people, poultry, retailed chicken meat ( n = 31), and (ii) from other sources studied in the recent past ( n = 47). WGS and core-genome analyses were implemented. Results: Twenty-four travellers returned colonized with ESC-R- ( n = 29) and/or CST-R- ( n = 8) Ec strains. Almost all ESC-R- Ec were CTX-M-15 producers and belonged to heterogeneous STs/core-genome STs (cgSTs), while mcr -positive strains were not found. Based on the strains' STs/cgSTs, only 20 subjects were colonized with ESC-R- and/or CST-R- Ec that were not present in their gut before the journey. Single nucleotide variant (SNV) analysis showed that three of these 20 travellers carried ESC-R- Ec (ST3489, ST3580, ST361) identical (0–20 SNVs) to those found in local people, chicken meat, or poultry. Three further subjects carried ESC-R- Ec (ST394, ST648, ST5173) identical or highly related (15–55 SNVs) to those previously reported in local people, fish, or water. Conclusions: This is the first known study comparing the ESC-R- and/or CST-R- Ec strains obtained from travellers and local sources using solid molecular methods. We showed that for at least one-third of the returning travellers the acquired antibiotic-resistant Ec had a corresponding strain among resident people, food, animal and/or environmental sources.