Colonisation with multi-resistant Enterobacteriaceae in hospitalised Danish patients with a history of recent travel: a cross-sectional study.

BACKGROUND

The global spread of multi-resistant Enterobacteriaceae is a new challenge in health care. Travelling in high endemic areas has been associated with colonisation. This study was performed among patients hospitalised for any reason, with recent travel abroad to identify the rate for colonisation with multi-resistant bacteria.

METHODS

In a 3-month period (2011) all patients admitted to a the Department of Infectious Diseases, Aarhus University Hospital, Denmark with a travel history within the last three months were screened for multi-drug resistant bacteria by a rectal swab.

RESULTS

A total of 88 adult patients were included. None were carriers of carbapenemase-producing bacilli. 12.5% were colonised with extended spectrum beta-lactamase producing Escherichia coli (ESBL-EC). Diarrhoea during travel was significantly associated with colonisation. More than 80% of the ESBL-EC colonised patients had been abroad longer than two weeks (P < 0.05). Less than 40% of patients with ESBL-EC had self-limiting diarrhoea at the time of admission.

CONCLUSIONS

A significant proportion of patients with a recent travel history was colonised with ESBL-EC at hospitalisation (12.5%). Less than half of the travellers with ESBL-EC had gastrointestinal symptoms. Diarrhoea during travel and travelling time > two weeks were associated with colonisation with ESBL-EC.