Acquisition of Multidrug-resistant Bacteria After Travel in the Tropics : Prevalence, Determinants and Length of Carriage

Bacterial multidrug resistance has long been a hospital problem. This changed in the last decade with the emergence in the community of Enterobacteriaceae producing CTX-M-type extended spectrum beta-lactamases (ESBL). These enzymes are produced mainly by Escherichia coli, the main digestive commensal bacteria in Man, and the first causative agent of community-acquired infections. These strains were isolated in the world with a very high community prevalence in the countries in the tropics, but still low in industrialized countries such as France. The steady increase in international tourism has created daily flux between these areas that could well be a major vehicle for ESBL. While we just reported in Europe Enterobacteriaceae resistant to almost all antibiotics, including production of NDM-1 carbapenemase, imported from the Indian subcontinent is urgently needed to control this phenomenon, quantify and characterize the acquisition of multidrug-resistant Enterobacteriaceae (MRE) by French travelers in the tropics.

Assumptions Travel in the tropics is a source of import of MRE in France.

Population concerned Adult volunteers in the vaccination center prior to a travel in the tropics.

Main objective Measured independently for each of the three main tropical areas (Latin America, Sub-Saharan Africa and Asia) the rate of acquisition of MRE intestinal (for production of ESBL, and / or cephalosporinase plasmid and / or of carbapenemase) in people returning from a trip to the tropics that led to early consultation in a vaccination center.

Objective (s) school (s)