Antimicrobial-Resistant Nontyphoidal Salmonella Infection Following International Travel—United States, 2018–2019

Details

• Alternative Title:
  J Infect Dis
• Personal Author:
  Ford, Laura ; Shah, Hazel J. ; Eikmeier, Dana ; Hanna, Samir ; Chen, Jessica ; Tagg, Kaitlin A. ; Langley, Gayle ; Payne, Daniel C. ; Plumb, Ian D.
• Description:
  Background.
  
  Antimicrobial resistance in nontyphoidal Salmonella (NTS) can limit treatment options. We assessed the contribution of international travel to antimicrobial-resistant NTS infections.
  
  Methods.
  
  We describe NTS infections that were reported to the Foodborne Diseases Active Surveillance Network during 2018–2019 and screened for genetic resistance determinants, including those conferring decreased susceptibility to first-line agents (ciprofloxacin, ceftriaxone, or azithromycin). We used multivariable logistic regression to assess the association between resistance and international travel during the 7 days before illness began. We estimated the contribution of international travel to resistance using population-attributable fractions, and we examined reported antimicrobial use.
  
  Results.
  
  Among 9301 NTS infections, 1159 (12%) occurred after recent international travel. Predicted resistance to first-line antimicrobials was more likely following travel; the adjusted odds ratio varied by travel region and was highest after travel to Asia (adjusted odds ratio, 7.2 [95% confidence interval, 5.5–9.5]). Overall, 19% (95% confidence interval, 17%–22%) of predicted resistance to first-line antimicrobials was attributable to international travel. More travelers than nontravelers receiving ciprofloxacin or other fluoroquinolones had isolates with predicted resistance to fluoroquinolones (29% vs 9%, respectively; P < .01).
  
  Conclusions.
  
  International travel is a substantial risk factor for antimicrobial-resistant NTS infections. Understanding risks of resistant infection could help target prevention efforts.
  
  
• Subjects:
  Anti-Bacterial Agents Anti-Infective Agents Ciprofloxacin Humans Microbial Sensitivity Tests Salmonella Salmonella Infections United States
• Keywords:
  Drug Resistance Foodborne Disease Salmonella Travel
• Source:
  J Infect Dis. 228(5):533-541
• Pubmed ID:
  37129066
• Pubmed Central ID:
  PMC10839744
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; CC/CDC HHSUnited States/
• Volume:
  228
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:c33e439230b0f4222581e300f9027cad2528ea330c486c9c761d850eb2339fdfb33b565fd50dbd0f3eb8eddc6c7edca941926a0589059cc53813282e105eb2d5
• Download URL:
  https://stacks.cdc.gov/view/cdc/147682/cdc_147682_DS1.pdf
• File Type:
  [PDF - 814.32 KB ]