Evidence map›Paper›PMID 38952011›Full record

ArticleJournal of travel medicine2025

Patient characteristics and antimicrobial susceptibility profiles of Escherichia coli and Klebsiella pneumoniae infections in international travellers: a GeoSentinel analysis.

Sarah L McGuinness, Stephen Muhi, Maya L Nadimpalli, Ahmed Babiker, Caroline Theunissen, Giacomo Stroffolini, Leonardo Motta, Federico Gobbi, Ralph Huits, Michael Libman and 2 more

Abstract read
In one paragraph

Article in Journal of travel medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Genomic Epidemiology of ClinicalAntibiotics (Basel, Switzerland) · 2026
    Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Sarah L McGuinnessInfectious Diseases Epidemiology Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.ORCID 0000-0002-5725-0102
Stephen MuhiDepartment of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia.
Maya L NadimpalliGangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.ORCID 0000-0002-6526-116X
Ahmed BabikerDivision of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Caroline TheunissenDepartment of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
Giacomo StroffoliniDepartment of Infectious/Tropical Diseases and Microbiology, IRCCS Sacro Cuore-Don Calabria, Negrar di Valpolicella, Verona, Italy.
Leonardo MottaDepartment of Infectious/Tropical Diseases and Microbiology, IRCCS Sacro Cuore-Don Calabria, Negrar di Valpolicella, Verona, Italy.
Federico GobbiDepartment of Infectious/Tropical Diseases and Microbiology, IRCCS Sacro Cuore-Don Calabria, Negrar di Valpolicella, Verona, Italy.
Ralph HuitsDepartment of Infectious/Tropical Diseases and Microbiology, IRCCS Sacro Cuore-Don Calabria, Negrar di Valpolicella, Verona, Italy.
Michael LibmanDepartment of Microbiology, J.D. MacLean Centre for Tropical Diseases, McGill University Health Centre, Montreal, QC, Canada.ORCID 0000-0003-3416-6482
Karin LederInfectious Diseases Epidemiology Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
GeoSentinel Network

Funding

Antibacterial Resistance Leadership Group (ARLG)UM1AI104681 · NIAID · DUKE UNIVERSITY · PI Vance G. Fowler, Henry F HENRY CHAMBERS · 2013 to 2026
$180.8M
Antibacterial Resistance Leadership Group Early Faculty Seedling AwardAntibacterial Resistance Leadership Group Early Investigator AwardCDC HHSGeoSentinelGlobal Surveillance Network of the International Society of Travel Medicine U01CK000632International Society of Travel MedicineItalian Ministry of HealthNational Health and Medical Research Council GNT2017229National Institute of Allergy and Infectious Diseases UM1AI104681NCEZID CDC HHS U01 CK000632NHMRC Postgraduate Scholarship GNT1191368NHMRC Senior Research Fellowship GNT1155005NIAID NIH HHS UM1 AI104681Public Health Agency of Canada
6 · The paper itself

Abstract

backgroundAntimicrobial resistance (AMR) is a global health crisis, with Enterobacterales, including Escherichia coli and Klebsiella pneumoniae, playing significant roles. While international travel to low- and middle-income countries is linked to colonization with AMR Enterobacterales, the clinical implications, particularly the risk of subsequent infection, remain unclear due to limited data. We aimed to characterize E. coli and K. pneumoniae infections in travellers and the antimicrobial susceptibility profiles of their isolates.

methodsWe analysed data on E. coli and K. pneumoniae infections in travellers collected at GeoSentinel sites between 2015 and 2022, focusing on epidemiological, clinical and microbiological characteristics. We defined multi-drug resistance (MDR) as non-susceptibility to agents from at least three drug classes.

resultsOver the 8-year period, we included 655 patients (median age 41 years; 74% female) from 57 sites in 27 countries, with 584 E. coli and 72 K. pneumoniae infections. Common travel regions included sub-Saharan Africa, Southeast Asia and South-Central Asia. Urinary tract infections predominated. Almost half (45%) were hospitalized. Among infections with antimicrobial susceptibility data across three or more drug classes, 203/544 (37%) E. coli and 19/67 (28%) K. pneumoniae demonstrated MDR. Over one-third of E. coli and K. pneumoniae isolates were non-susceptible to third-generation cephalosporins and cotrimoxazole, with 38% and 28% non-susceptible to fluoroquinolones, respectively. Travellers to South-Central Asia most frequently had isolates non-susceptible to third-generation cephalosporins, fluoroquinolones and carbapenems. We observed increasing frequencies of phenotypic extended spectrum beta-lactamase and carbapenem resistance over time.

conclusionsE. coli and K. pneumoniae infections in travellers, particularly those to Asia, may be challenging to empirically treat. Our analysis highlights the significant health risks these infections pose to travellers and emphasizes the escalating global threat of AMR. Enhanced, systematic AMR surveillance in travellers is needed, along with prospective data on infection risk post travel-related AMR organism acquisition.

Indexed as

Anti-Bacterial AgentsEscherichia coliEscherichia coli InfectionsKlebsiella InfectionsKlebsiella pneumoniaeTravelAdolescentAdultAgedDrug Resistance, Multiple, BacterialFemaleGlobal HealthHumansMaleMicrobial Sensitivity TestsMiddle AgedAnti-Bacterial Agentsantimicrobial resistanceESBLEscherichia coliKlebsiella pneumoniaetravel

Identifiers

PMID38952011
PMCPMC11789195

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

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.