ArticleThe Lancet. Microbe2023
Gut microbiome perturbation, antibiotic resistance, and Escherichia coli strain dynamics associated with international travel: a metagenomic analysis.
Article in The Lancet. Microbe, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
What it found
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Who cites it
34 citing papers in PubMed, 41 citations in OpenAlex.
- The Effect of a Probiotic on Gut Microbiota Stability and Systemic Well-Being during Short-Term Travel.Journal of microbiology and biotechnology · 2026Trial
- The healthy human gut as a covert reservoir for mobile antimicrobial resistance: nationwide genomic surveillance of Enterobacter cloacae complex in China.BMC microbiology · 2026Article
- Profiling the gut resistome to unlock antimicrobial resistance biology and inform clinical risk.Nature communications · 2026Review
- Modelling the role of the microbiome in antimicrobial resistance across scales.Nature microbiology · 2026Review
- Population-Level Uncoupling of Antimicrobial Usage and Resistance in Community-OnsetPathogens (Basel, Switzerland) · 2026Article
- Domestic travel as a driver for the dissemination ofAntimicrobial agents and chemotherapy · 2026Article
- Travel-Induced Circadian and Microbiota Disturbances: Implications for Athlete Health and Performance: A Narrative Review.Nutrients · 2026Review
- Daily sampling reveals rapid microbiota alterations and antimicrobial resistance gene acquisition during intercontinental travel.NPJ biofilms and microbiomes · 2026Article
- Bacteriophage Therapy AgainstAntibiotics (Basel, Switzerland) · 2026Review
- Global resistome architecture of Escherichia coli across human and animal hosts: analysis of 9,696 genome.BMC microbiology · 2026Article
- Metagenomic strain tracking reveals patterns of bacterial spread and the impact of water chlorination.medRxiv : the preprint server for health sciences · 2026Article
- Gut microbiota and resistome profiles of Swiss expatriates in Africa revealed by Nanopore metagenomics.Scientific reports · 2026Article
- Insights Into Global Antimicrobial Resistance Dynamics Through the Sequencing of Enteric Bacteria From US International Travelers.The Journal of infectious diseases · 2026Article
- Intestinal microbiome gone native: gut microbiome shift and resistome diversity in first homecoming giant panda family.Frontiers in microbiology · 2026Article
- The impact of different antimicrobial exposures on the gut microbiome in the ARMORD observational study.eLife · 2025Observational
- Role of the gut microbiome in frequent gut colonization with extended-spectrum β lactamase-producing Enterobacterales among Peruvian children.Gut microbes · 2025Article
- Using wastewater surveillance to investigate community-level differences in antibacterial resistance in a major urban center, USA.Applied and environmental microbiology · 2025Article
- Gut Microbiome and Intestinal Colonization with Multidrug-Resistant Strains of Enterobacterales: An Interplay Between Microbial Communities.Antibiotics (Basel, Switzerland) · 2025Review
- Refining microbiome diversity analysis by concatenating and integrating dual 16S rRNA amplicon reads.NPJ biofilms and microbiomes · 2025Article
- Advancing Gut Microbiome Research: The Shift from Metagenomics to Multi-Omics and Future Perspectives.Journal of microbiology and biotechnology · 2025Review
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Authors and funding
19 authors at 11 institutions in 1 country.
Funding
Abstract
backgroundCulture-based studies have shown that acquisition of extended-spectrum β-lactamase-producing Enterobacterales is common during international travel; however, little is known about the role of the gut microbiome before and during travel, nor about acquisition of other antimicrobial-resistant organisms. We aimed to identify (1) whether the gut microbiome provided colonisation resistance against antimicrobial-resistant organism acquisition, (2) the effect of travel and travel behaviours on the gut microbiome, and (3) the scale and global heterogeneity of antimicrobial-resistant organism acquisition.
methodsIn this metagenomic analysis, participants were recruited at three US travel clinics (Boston, MA; New York, NY; and Salt Lake City, UT) before international travel. Participants had to travel internationally between Dec 8, 2017, and April 30, 2019, and have DNA extractions for stool samples both before and after travel for inclusion. Participants were excluded if they had at least one low coverage sample (<1 million read pairs). Stool samples were collected at home before and after travel, sent to a clinical microbiology laboratory to be screened for three target antimicrobial-resistant organisms (extended-spectrum β-lactamase-producing Enterobacterales, carbapenem-resistant Enterobacterales, and mcr-mediated colistin-resistant Enterobacterales), and underwent DNA extraction and shotgun metagenomic sequencing. We profiled metagenomes for taxonomic composition, antibiotic-resistant gene content, and characterised the Escherichia coli population at the strain level. We analysed pre-travel samples to identify the gut microbiome risk factors associated with acquisition of the three targeted antimicrobial resistant organisms. Pre-travel and post-travel samples were compared to identify microbiome and resistome perturbation and E coli strain acquisition associated with travel.
findingsA total of 368 individuals travelled between the required dates, and 296 had DNA extractions available for both before and after travel. 29 travellers were excluded as they had at least one low coverage sample, leaving a final group of 267 participants. We observed a perturbation of the gut microbiota, characterised by a significant depletion of microbial diversity and enrichment of the Enterobacteriaceae family. Metagenomic strain tracking confirmed that 67% of travellers acquired new strains of E coli during travel that were phylogenetically distinct from their pre-travel strains. We observed widespread enrichment of antibiotic-resistant genes in the gut, with a median 15% (95% CI 10-20, p<1 × 10
interpretationThis work highlights a scale of E coli and antimicrobial-resistant organism acquisition by US travellers not apparent from previous culture-based studies, and suggests that strategies to control antimicrobial-resistant organisms addressing international traveller behaviour, rather than modulating the gut microbiome, could be worthwhile.
fundingUS Centers for Disease Control and Prevention and National Institute of Allergy and Infectious Diseases.
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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.