Gut microbiome perturbation, antibiotic resistance, and Escherichia coli strain dynamics associated with international travel: a metagenomic analysis

• Published in: The Lancet. Microbe 2023-10, Vol.4 (10), p.e790-e799
• Main Authors: Worby, Colin J, Sridhar, Sushmita, Turbett, Sarah E, Becker, Margaret V, Kogut, Lucyna, Sanchez, Vanessa, Bronson, Ryan A, Rao, Sowmya R, Oliver, Elizabeth, Walker, Allison Taylor, Walters, Maroya Spalding, Kelly, Paul, Leung, Daniel T, Knouse, Mark C, Hagmann, Stefan H F, Harris, Jason B, Ryan, Edward T, Earl, Ashlee M, LaRocque, Regina C
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; beta-Lactamases - genetics; DNA; Drug Resistance, Microbial; Escherichia coli - genetics; Gastrointestinal Microbiome - genetics; Humans; Metagenome; Travel; Travel-Related Illness; United States
• ISSN: 2666-5247; 2666-5247
• DOI: 10.1016/S2666-5247(23)00147-7

Culture-based studies have shown that acquisition of extended-spectrum β-lactamase-producing Enterobacterales is common during international travel; however, little is known about the role of the gut microbiome before and during travel, nor about acquisition of other antimicrobial-resistant organisms. We aimed to identify (1) whether the gut microbiome provided colonisation resistance against antimicrobial-resistant organism acquisition, (2) the effect of travel and travel behaviours on the gut microbiome, and (3) the scale and global heterogeneity of antimicrobial-resistant organism acquisition. In this metagenomic analysis, participants were recruited at three US travel clinics (Boston, MA; New York, NY; and Salt Lake City, UT) before international travel. Participants had to travel internationally between Dec 8, 2017, and April 30, 2019, and have DNA extractions for stool samples both before and after travel for inclusion. Participants were excluded if they had at least one low coverage sample (