Microbiome and Antimicrobial Resistance Gene Dynamics in International Travelers

Langelier, Charles; Graves, Michael C.; Kalantar, Katrina; Caldera, Saharai; Durrant, Robert J.; Fisher, Mark A.; Backman, Richard; Tanner, Windy; DeRisi, Joseph L.; Leung, Daniel T.

doi:10.3201/eid2507.181492

Cited by 34 publications

(27 citation statements)

References 14 publications

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“…Thus, ARGs may amplify or change genetic background within animal vectors, which may constitute a reservoir of antibiotic resistance. Humans are the most studied animal vector (e.g., [107,108]). Farmers and other workers in direct contact with livestock have been shown to develop increased resistance [109,110,111,112].…”

Section: An Overview Of Antibiotic Resistance In the Environmentmentioning

confidence: 99%

“…In addition to health care, farm, and WWTP workers, the dissemination of ARBs has been connected to international travellers. Several studies have demonstrated that commensals and pathogens carrying ARGs can establish themselves in the travellers’ microbiome, and that these ARBs can persist for a length of time after return to the country of origin [107,108]. For example, Swedish students undergoing an exchange to India were significantly more likely to return home carrying E. coli with ESBL genes than those staying in Central Africa, and establishment of ARB strains in the students’ microbiomes occurred without any antibiotic treatment [107].…”

Section: An Overview Of Antibiotic Resistance In the Environmentmentioning

confidence: 99%

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Antibiotic Pollution in the Environment: From Microbial Ecology to Public Policy

2019

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The ability to fight bacterial infections with antibiotics has been a longstanding cornerstone of modern medicine. However, wide-spread overuse and misuse of antibiotics has led to unintended consequences, which in turn require large-scale changes of policy for mitigation. In this review, we address two broad classes of corollaries of antibiotics overuse and misuse. Firstly, we discuss the spread of antibiotic resistance from hotspots of resistance evolution to the environment, with special concerns given to potential vectors of resistance transmission. Secondly, we outline the effects of antibiotic pollution independent of resistance evolution on natural microbial populations, as well as invertebrates and vertebrates. We close with an overview of current regional policies tasked with curbing the effects of antibiotics pollution and outline areas in which such policies are still under development.

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Section: An Overview Of Antibiotic Resistance In the Environmentmentioning

confidence: 99%

Section: An Overview Of Antibiotic Resistance In the Environmentmentioning

confidence: 99%

Antibiotic Pollution in the Environment: From Microbial Ecology to Public Policy

2019

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“…However, current knowledge on the link between the microbiome and MDRO colonisation is limited [ 12 , 13 ]. In travellers, an increase of antimicrobial resistance genes and Escherichia coli relative abundance in the microbiome were observed after acquisition and asymptomatic carriage of extended-spectrum beta-lactamase (ESBL)-producing E. coli , but without clear differences in microbial community structure [ 14 ]. An exception to the understudied role of the microbiome in MDRO colonisation is vancomycin-resistant Enteroccocus (VRE).…”

Section: Introductionmentioning

confidence: 99%

Microbiota-associated risk factors for asymptomatic gut colonisation with multi-drug-resistant organisms in a Dutch nursing home

et al. 2021

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Background Nursing home residents have increased rates of intestinal colonisation with multidrug-resistant organisms (MDROs). We assessed the colonisation and spread of MDROs among this population, determined clinical risk factors for MDRO colonisation and investigated the role of the gut microbiota in providing colonisation resistance against MDROs. Methods We conducted a prospective cohort study in a Dutch nursing home. Demographical, epidemiological and clinical data were collected at four time points with 2-month intervals (October 2016–April 2017). To obtain longitudinal data, faecal samples from residents were collected for at least two time points. Ultimately, twenty-seven residents were included in the study and 93 faecal samples were analysed, of which 27 (29.0%) were MDRO-positive. Twelve residents (44.4%) were colonised with an MDRO at at least one time point throughout the 6-month study. Results Univariable generalised estimating equation logistic regression indicated that antibiotic use in the previous 2 months and hospital admittance in the previous year were associated with MDRO colonisation. Characterisation of MDRO isolates through whole-genome sequencing revealed Escherichia coli sequence type (ST)131 to be the most prevalent MDRO and ward-specific clusters of E. coli ST131 were identified. Microbiota analysis by 16S rRNA gene amplicon sequencing revealed no differences in alpha or beta diversity between MDRO-positive and negative samples, nor between residents who were ever or never colonised. Three bacterial taxa (Dorea, Atopobiaceae and Lachnospiraceae ND3007 group) were more abundant in residents never colonised with an MDRO throughout the 6-month study. An unexpectedly high abundance of Bifidobacterium was observed in several residents. Further investigation of a subset of samples with metagenomics showed that various Bifidobacterium species were highly abundant, of which B. longum strains remained identical within residents over time, but were different between residents. Conclusions Our study provides new evidence for the role of the gut microbiota in colonisation resistance against MDROs in the elderly living in a nursing home setting. Dorea, Atopobiaceae and Lachnospiraceae ND3007 group may be associated with protection against MDRO colonisation. Furthermore, we report a uniquely high abundance of several Bifidobacterium species in multiple residents and excluded the possibility that this was due to probiotic supplementation.

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“…Overall, this will have lessened the exposure to a range of external environmental microbiota. Pre-pandemic, international travellers had a higher proportion of Escherichia species and increased antimicrobial resistance genes ( 27 ). While it is known that travel is a modifying factor for the adult microbiome ( 28 ), we do not know the effect of an absence of travel on the microbiome.…”

Section: Indirect Effects Of Pandemic On An Individual or Populationsmentioning

confidence: 99%

The Unique Impact of COVID-19 on Human Gut Microbiome Research

et al. 2021

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The coronavirus (COVID-19) pandemic has disrupted clinical trials globally, with unique implications for research into the human gut microbiome. In this mini-review, we explore the direct and indirect influences of the pandemic on the gut microbiome and how these can affect research and clinical trials. We explore the direct bidirectional relationships between the COVID-19 virus and the gut and lung microbiomes. We then consider the significant indirect effects of the pandemic, such as repeated lockdowns, increased hand hygiene, and changes to mood and diet, that could all lead to longstanding changes to the gut microbiome at an individual and a population level. Together, these changes may affect long term microbiome research, both in observational as well as in population studies, requiring urgent attention. Finally, we explore the unique implications for clinical trials using faecal microbiota transplants (FMT), which are increasingly investigated as potential treatments for a range of diseases. The pandemic introduces new barriers to participation in trials, while the direct and indirect effects laid out above can present a confounding factor. This affects recruitment and sample size, as well as study design and statistical analyses. Therefore, the potential impact of the pandemic on gut microbiome research is significant and needs to be specifically addressed by the research community and funders.

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Microbiome and Antimicrobial Resistance Gene Dynamics in International Travelers

Cited by 34 publications

References 14 publications

Antibiotic Pollution in the Environment: From Microbial Ecology to Public Policy

Antibiotic Pollution in the Environment: From Microbial Ecology to Public Policy

Microbiota-associated risk factors for asymptomatic gut colonisation with multi-drug-resistant organisms in a Dutch nursing home

The Unique Impact of COVID-19 on Human Gut Microbiome Research

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