ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2015
Antimicrobials increase travelers' risk of colonization by extended-spectrum betalactamase-producing Enterobacteriaceae.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03306407 (A Multicentre Intervention Study on the Use of Hand Sanitizers in the Prevention of Intestinal Colonization With Extended-spectrum Beta-lactamase-producing Enterobacteriaceae in Travellers to the Indian Subcontinent), which is not on this map. Cited by 117 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Multicentre Intervention Study on the Use of Hand Sanitizers in the Prevention of Intestinal Colonization With Extended-spectrum Beta-lactamase-producing Enterobacteriaceae in Travellers to the Indian Subcontinent
Who cites it
117 citing papers in PubMed, 4 syntheses or guidelines pooled it, 313 citations in OpenAlex.
- 45 years of tetracycline post exposure prophylaxis for STIs and the risk of tetracycline resistance: a systematic review and meta-analysis.BMC infectious diseases · 2024Pooled it
- Acquisition of multidrug-resistant Enterobacterales during international travel: a systematic review of clinical and microbiological characteristics and meta-analyses of risk factors.Antimicrobial resistance and infection control · 2020Pooled it
- ACG Clinical Guideline: Diagnosis, Treatment, and Prevention of Acute Diarrheal Infections in Adults.The American journal of gastroenterology · 2016Guideline
- [Diagnostic workup and therapy of infectious diarrhea. Current standards].Der Internist · 2015Guideline
- Development of a new travellers' diarrhoea clinical severity classification and its utility in confirming rifamycin-SV efficacy.Journal of travel medicine · 2023Trial
- Rifamycin SV-MMX® for treatment of travellers' diarrhea: equally effective as ciprofloxacin and not associated with the acquisition of multi-drug resistant bacteria.Journal of travel medicine · 2018Trial
- Trial Evaluating Ambulatory Therapy of Travelers' Diarrhea (TrEAT TD) Study: A Randomized Controlled Trial Comparing 3 Single-Dose Antibiotic Regimens With Loperamide.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Trial
- Safety and Immunogenicity of a Candidate Bioconjugate Vaccine against Shigella flexneri 2a Administered to Healthy Adults: a Single-Blind, Randomized Phase I Study.Clinical and vaccine immunology : CVI · 2016Trial
- Molecular characterisation of extended-Spectrum-Beta-lactamase-producingOne health (Amsterdam, Netherlands) · 2026Article
- Colonization with multidrug-resistant bacteria among children hospitalized abroad-a study from Finland.Journal of travel medicine · 2026Article
- Incidence and outcomes for colonization of multidrug-resistance organisms (MDROs) among patients undergoing elective orthopedic surgery.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Probiotics and Antibiotics Use for the Prevention of Travelers' Diarrhea Among Polish Tourists-Results from an Online Survey: Why Is Education Needed?Antibiotics (Basel, Switzerland) · 2025Article
- Epidemiology and risk factors ofEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
- Comparative epidemiology of Ghanaian individuals with molecular proof of Entamoeba histolytica with and without concomitant human immunodeficiency virus infection.European journal of microbiology & immunology · 2025Article
- Travel to low- and middle-income countries and travellers' diarrhoea increase risk of mismatching antimicrobial therapy for urinary tract infection.Journal of travel medicine · 2025Article
- Analysis of ESAC-Net/EARS-Net Data from 29 EEA Countries for Spatiotemporal Associations Between Antimicrobial Use and Resistance-Implications for Antimicrobial Stewardship?Antibiotics (Basel, Switzerland) · 2025Article
- Wastewater based genomic surveillance key to population level monitoring of AmpC/ESBL producing Escherichia coli.Scientific reports · 2025Article
- Using Unannounced Standardized Patients to Assess the Quality of Tuberculosis Care and Antibiotic Prescribing: A Cross-Sectional Study on a Low/Middle-Income Country, Pakistan.Antibiotics (Basel, Switzerland) · 2025Article
- Patient characteristics and antimicrobial susceptibility profiles of Escherichia coli and Klebsiella pneumoniae infections in international travellers: a GeoSentinel analysis.Journal of travel medicine · 2025Article
- Risk of Colonization with Multidrug-Resistant Gram-Negative Bacteria Among Travellers and Migrants: A Narrative Review.Tropical medicine and infectious disease · 2025Review
57 more citing papers are in PubMed but not listed here.
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMore than 300 million travelers visit regions with poor hygiene annually. A significant percentage of them become colonized by resistant intestinal bacteria such as extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) and may transmit the strains to others and to medical care settings when they return home. Despite the threats to global healthcare caused by an upsurge in antimicrobial resistance, no effort has been centered on prevention of colonization while traveling.
methodsStool samples were collected from 430 Finns before and after traveling outside Scandinavia. All specimens were analyzed for ESBL- and carbapenemase-producing Enterobacteriaceae (CPE). Questionnaires were used to survey volunteers about use of antimicrobials as well as other potential risk factors. The results were subjected to multivariable analysis.
resultsTwenty-one percent (90/430) of the travelers became colonized by ESBL-PE and none by CPE. Geographic region, occurrence of travelers' diarrhea (TD), age, and use of antimicrobial (AB) for TD were identified as independent risk factors predisposing to contracting ESBL-PE. Eleven percent of those in subgroup TD-AB-, 21% in TD+AB-, and 37% in TD+AB+ acquired ESBL-PE. The risk proved to be highest in South Asia (46%); 23% became colonized in subgroup TD-AB-, 47% in TD+AB-, and 80% in TD+AB+. In Southeast Asia, the rates were 14%, 37%, and 69%, respectively.
conclusionsTD and antimicrobials for TD proved to be independent risk factors, with up to 80% of TD+AB+ travelers contracting ESBL-PE. In modern pre-travel counseling for those visiting high-risk regions, travelers should be advised against taking antibiotics for mild or moderate TD.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.