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Travel and the Spread of Drug-Resistant Bacteria

  • Tropical, Travel, and Emerging Infections (L Chen and A Boggild, Section Editors)
  • Published:
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Abstract

Purpose of Review

The rise in antimicrobial resistance is an urgent public health threat which, in the absence of intervention, may result in a post-antibiotic era limiting the effectiveness of antibiotics to treat both common and serious infections. Globalization and human migration have profoundly contributed to the spread of drug-resistant bacteria. In this review, we summarize the recent literature on the importance of travelers in the spread of drug-resistant bacterial organisms. Our goal was to describe the importance of travel on a variety of clinically relevant drug-resistant bacterial organisms including extended-spectrum β-lactamase-producing Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae, methicillin-resistant Staphylococcus aureus, Salmonella species, as well as other enteric infections.

Recent Findings

Travelers from high income countries, visiting low and middle income countries, frequently acquire drug-resistant bacteria, particularly extended-spectrum β-lactamase-producing Enterobacteriaceae. The highest risk is associated with travel to the Indian subcontinent. Multidrug-resistant enteric infections in travelers from Salmonella spp., Campylobacter spp., and Shigella spp. are increasing. Refugees, pilgrimages, and medical tourists are associated with considerable risk of multiple forms of drug resistance.

Summary

This review highlights the importance of antimicrobial stewardship, infection control, and surveillance; particularly in low and middle income countries. International leadership with global coordination is vital in the battle against antimicrobial resistance.

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Acknowledgements

We would like to thank Sean Marshall from Public Health Ontario for creating the map figure.

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Authors and Affiliations

  1. Public Health Ontario, 480 University Ave, suite 300, Toronto, Ontario, M5G 1V2, Canada

    Kevin L. Schwartz

  2. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada

    Kevin L. Schwartz & Shaun K. Morris

  3. St. Joseph’s Health Centre, Toronto, Ontario, Canada

    Kevin L. Schwartz

  4. Division of Infectious Diseases, The Hospital for Sick Children, Toronto, Ontario, Canada

    Shaun K. Morris

  5. Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

    Shaun K. Morris

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  1. Kevin L. Schwartz
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Correspondence to Kevin L. Schwartz.

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Kevin Schwartz and Shaun Morris declare that they have no conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Tropical, Travel, and Emerging Infections

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Schwartz, K.L., Morris, S.K. Travel and the Spread of Drug-Resistant Bacteria. Curr Infect Dis Rep 20, 29 (2018). https://doi.org/10.1007/s11908-018-0634-9

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