Global trends in travel-related antimicrobial resistance: a systematic review, 2020-2024.

Antimicrobial resistance (AMR) is a growing global health threat, with international travel playing a key role in the spread of resistant bacteria. This systematic review examines trends in travel-associated AMR from 2020 to 2024. A search of PubMed, Scopus and Web of Science identified 10 studies involving 359 AMR isolates. Using the Newcastle-Ottawa scale, the study quality was assessed and findings were synthesised to identify patterns in prevalence, diversity and geographic spread. Results revealed a consistent rise in travel-associated AMR, particularly from regions such as Southeast Asia and Africa, which acted as major sources of diverse resistant pathogens. These include extended spectrum beta-lactamase-producing Escherichia coli, multidrug-resistant (MDR) Corynebacterium diphtheriae and colistin-resistant Enterobacterales. The number of MDR strains increased over time, making up 15.3% of cases by 2024. Healthcare exposure during travel emerged as a significant risk factor. Overall, the prevalence and diversity of AMR bacteria linked to travel have risen steadily, highlighting the urgent need for global cooperation. Enhanced surveillance, antimicrobial stewardship, infection control measures and international collaboration are essential to curb the spread of these dangerous pathogens.