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:
  • Humans
  • United States
  • Microbial Sensitivity Tests
  • Salmonella Infections
  • Salmonella
  • Ciprofloxacin
  • Anti-Infective Agents
  • Anti-Bacterial Agents
• Keywords:
  • salmonella
  • drug resistance
  • foodborne disease
  • 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
• Download URL:
  https://stacks.cdc.gov/view/cdc/147682/cdc_147682_DS1.pdf
• File Type:
  [PDF - 814.32 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:c33e439230b0f4222581e300f9027cad2528ea330c486c9c761d850eb2339fdfb33b565fd50dbd0f3eb8eddc6c7edca941926a0589059cc53813282e105eb2d5