High colonization rates of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli in Swiss Travellers to South Asia- a prospective observational multicentre cohort study looking at epidemiology, microbiology and risk factors.

BACKGROUND International travel contributes to the worldwide spread of multidrug resistant Gram-negative bacteria. Rates of travel-related faecal colonization with extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae vary for different destinations. Especially travellers returning from the Indian subcontinent show high colonization rates. So far, nothing is known about region-specific risk factors for becoming colonized. METHODS An observational prospective multicentre cohort study investigated travellers to South Asia. Before and after travelling, rectal swabs were screened for third-generation cephalosporin- and carbapenem-resistant Enterobacteriaceae. Participants completed questionnaires to identify risk factors for becoming colonized. Covariates were assessed univariately, followed by a multivariate regression. RESULTS Hundred and seventy persons were enrolled, the largest data set on travellers to the Indian subcontinent so far. The acquired colonization rate with ESBL-producing Escherichia coli overall was 69.4% (95% CI 62.1-75.9%), being highest in travellers returning from India (86.8%; 95% CI 78.5-95.0%) and lowest in travellers returning from Sri Lanka (34.7%; 95% CI 22.9-48.7%). Associated risk factors were travel destination, length of stay, visiting friends and relatives, and eating ice cream and pastry. CONCLUSIONS High colonization rates with ESBL-producing Enterobacteriaceae were found in travellers returning from South Asia. Though risk factors were identified, a more common source, i.e. environmental, appears to better explain the high colonization rates.

Wie sich der heil. Johannes v. Nepomuk auf der Moldaubrücke mit dem Hintern gegen die Alt- und Neustadt umgekehrt hat, oder wunderbare und wahrhaftige Geschichte, welche sich am 2. Juli, im Jahre des Heils 1848 in Prag zugetragen hat: In der Nacht vom 1. auf den 2. Juli d. J., also vom Samstage auf den Sonntag dieser Woche ...

Welsch (Projektbearbeiter): Satire von pro-tschechischer Seite nach der Niederschlagung des Prager Pfingstaufstandes (17. Juni 1848). Der heilige Johannes von Nepomuk wurde als Symbol des habsburgischen Katholizismus sowie als Gegenbild zu Jan Hus von der nationaltschechischen Bewegung abgelehnt

Zur Charakteristik Johannes Pfefferkorns

Meier Spanier

Johannes Keppler

Richard Loewe