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Global travellers more prone to drug-resistant bacteria

Global travellers may be particularly vulnerable to drug-resistant strains of bacteria, according to a recent study.

The research, led by scientists at the Universities of Basel, Birmingham, Helsinki and Oslo and the Wellcome Sanger Institute, was published in The Lancet Microbe. The study monitored a group of European travellers to the Lao People’s Democratic Republic over a three week period, tracking stool samples to analyse gut microbiome over the period.

Antimicrobial resistance tests. Image credit: Dr Graham Beards, CC BY-SA 4.0 , via Wikimedia Commons, antibiotic resistant
Antimicrobial resistance tests. Image credit: Dr Graham Beards, CC BY-SA 4.0 <>, via Wikimedia Commons

The study focused on the presence of multi-drug resistant gram-negative (MDR-GN) bacteria, one deemed to be a major risk to public health across the globe. The findings indicated that the strain passed rapidly between those travellers in contact with one another. One exceptional instance noted that a traveller contracted the resistant strain from another simply through taking a shower in the others bathroom.

“Our study reveals the true scale and complexity at which drug-resistant bacteria colonise the intestinal tract during travel, demonstrating that it has been seriously underestimated previously,” said study co-senior author Jukka Corander of the Associate Faculty at the Wellcome Sanger Institute and professor at the Faculty of Medicine at the University of Oslo in comments to BBC. “In addition, several of our participants lost some of their travel-acquired ESBL-GN strains while still abroad – indicating that previous studies solely employing pre- and post-travel sampling have under-reported the extent to which travellers are colonised by ESBL-GN.”

Alan McNally, professor in microbial evolutionary genomics at the University of Birmingham and a senior author of the study, said “International travel is strongly linked to the spread of MDR-GN bacteria, with transmission highest in India and Southeast Asia, Africa and South America. Travellers visiting these high-risk regions are at substantial risk of acquiring the bacteria.”

India is no stranger to drug resistance. As an international travel hub, these findings are particularly relevant to the country, though there is no shortage of domestic issues exacerbating the problem. 

According to a study by researchers at the Center for Disease Dynamics, Economics and Policy, published in The Lancet Infectious Diseases, India is one of the top culprits for overconsumption of so-called “Watch” antibiotics. The World Health Organization (WHO) defines the Watch antibiotics group as “antibiotics that have higher resistance potential and includes most of the highest priority agents among the Critically Important Antimicrobials for Human Medicine and/or antibiotics that are at relatively high risk of selection of bacterial resistance.”

Overconsumption of antibiotics is a problem both within healthcare, as well as in animal husbandry. Antibiotics given to livestock animals are noted as a key driver of antibiotic resistance in India. 

Dire warnings are in place should the situation be allowed to continue out of control. Concerns have been raised regarding multi-drug resistant strains of tuberculosis. Some strains are now shown to be resistant to even third-line therapies, raising concerns that strains may develop that are all but impossible to treat. The situation for tuberculosis serves as a warning. Drug resistance is developing in a host of diseases and the longer it is left to fester, the more difficult the situation will be to address in the future.

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