Risk of acquisition of human diarrhoeagenic Escherichia coli virulence genes in intercontinental travellers: A prospective, multi-centre study

COMBAT Consortium

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: We studied geographic distribution of diarrhoeagenic Escherichia coli virulence genes (DEC VGs) acquisition in travellers and investigated if they acquired highly virulent EAEC/STEC hybrid strains. Methods: From the prospective, multicentre COMBAT study among 2001 Dutch travellers, 491 travellers were selected based on travel destination to 7 subregions. Faecal samples taken directly before and after travel were screened for nine DEC VGs with real-time PCR. Incidence proportions and rates were calculated for each gene and subregion. Results: 479 travellers were analysed. 21.8% acquired aggR (EAEC), with highest acquisition rates in Northern and Western Africa and 15.3% acquired eae (STEC/EPEC) with highest rates in travellers to Western and Eastern Africa. ETEC (elt or est gene) was acquired by 4.2% of travellers and acquisition of est was associated with traveller's diarrhoea. Overall, the risk of acquiring DEC VGs was low in Southern Africa and South America. Although the combination of aggR (EAEC) and stx1/2 (STEC) was acquired by 3 travellers, these genes could not be detected together in a single E. coli strain. Conclusions: The risk of acquisition of DEC VGs strongly depends on the travel destination, with those travelling to Africa - except Southern Africa - having a higher risk.
Original languageEnglish
JournalTravel Medicine and Infectious Disease
DOIs
Publication statusE-pub ahead of print - 2019

Cite this

@article{752813cc396d4513a08ccbfe8bd9c118,
title = "Risk of acquisition of human diarrhoeagenic Escherichia coli virulence genes in intercontinental travellers: A prospective, multi-centre study",
abstract = "Background: We studied geographic distribution of diarrhoeagenic Escherichia coli virulence genes (DEC VGs) acquisition in travellers and investigated if they acquired highly virulent EAEC/STEC hybrid strains. Methods: From the prospective, multicentre COMBAT study among 2001 Dutch travellers, 491 travellers were selected based on travel destination to 7 subregions. Faecal samples taken directly before and after travel were screened for nine DEC VGs with real-time PCR. Incidence proportions and rates were calculated for each gene and subregion. Results: 479 travellers were analysed. 21.8{\%} acquired aggR (EAEC), with highest acquisition rates in Northern and Western Africa and 15.3{\%} acquired eae (STEC/EPEC) with highest rates in travellers to Western and Eastern Africa. ETEC (elt or est gene) was acquired by 4.2{\%} of travellers and acquisition of est was associated with traveller's diarrhoea. Overall, the risk of acquiring DEC VGs was low in Southern Africa and South America. Although the combination of aggR (EAEC) and stx1/2 (STEC) was acquired by 3 travellers, these genes could not be detected together in a single E. coli strain. Conclusions: The risk of acquisition of DEC VGs strongly depends on the travel destination, with those travelling to Africa - except Southern Africa - having a higher risk.",
author = "{COMBAT Consortium} and {van Hattem}, {Jarne M.} and Adriana Cabal and Arcilla, {Maris S.} and Julio Alvarez and {de Jong}, {Menno D.} and Melles, {Damian C.} and John Penders and Bootsma, {Martin C. J.} and {van Genderen}, {Perry J.} and Abraham Goorhuis and Martin Grobusch and Nicky Molhoek and {Oude Lashof}, {Astrid M. L.} and Stobberingh, {Ellen E.} and Verbrugh, {Henri A.} and Schmidt, {Christian Gort{\'a}zar} and Constance Schultsz",
year = "2019",
doi = "10.1016/j.tmaid.2018.12.005",
language = "English",
journal = "Travel Medicine and Infectious Disease",
issn = "1477-8939",
publisher = "Elsevier USA",

}

TY - JOUR

T1 - Risk of acquisition of human diarrhoeagenic Escherichia coli virulence genes in intercontinental travellers: A prospective, multi-centre study

AU - COMBAT Consortium

AU - van Hattem, Jarne M.

AU - Cabal, Adriana

AU - Arcilla, Maris S.

AU - Alvarez, Julio

AU - de Jong, Menno D.

AU - Melles, Damian C.

AU - Penders, John

AU - Bootsma, Martin C. J.

AU - van Genderen, Perry J.

AU - Goorhuis, Abraham

AU - Grobusch, Martin

AU - Molhoek, Nicky

AU - Oude Lashof, Astrid M. L.

AU - Stobberingh, Ellen E.

AU - Verbrugh, Henri A.

AU - Schmidt, Christian Gortázar

AU - Schultsz, Constance

PY - 2019

Y1 - 2019

N2 - Background: We studied geographic distribution of diarrhoeagenic Escherichia coli virulence genes (DEC VGs) acquisition in travellers and investigated if they acquired highly virulent EAEC/STEC hybrid strains. Methods: From the prospective, multicentre COMBAT study among 2001 Dutch travellers, 491 travellers were selected based on travel destination to 7 subregions. Faecal samples taken directly before and after travel were screened for nine DEC VGs with real-time PCR. Incidence proportions and rates were calculated for each gene and subregion. Results: 479 travellers were analysed. 21.8% acquired aggR (EAEC), with highest acquisition rates in Northern and Western Africa and 15.3% acquired eae (STEC/EPEC) with highest rates in travellers to Western and Eastern Africa. ETEC (elt or est gene) was acquired by 4.2% of travellers and acquisition of est was associated with traveller's diarrhoea. Overall, the risk of acquiring DEC VGs was low in Southern Africa and South America. Although the combination of aggR (EAEC) and stx1/2 (STEC) was acquired by 3 travellers, these genes could not be detected together in a single E. coli strain. Conclusions: The risk of acquisition of DEC VGs strongly depends on the travel destination, with those travelling to Africa - except Southern Africa - having a higher risk.

AB - Background: We studied geographic distribution of diarrhoeagenic Escherichia coli virulence genes (DEC VGs) acquisition in travellers and investigated if they acquired highly virulent EAEC/STEC hybrid strains. Methods: From the prospective, multicentre COMBAT study among 2001 Dutch travellers, 491 travellers were selected based on travel destination to 7 subregions. Faecal samples taken directly before and after travel were screened for nine DEC VGs with real-time PCR. Incidence proportions and rates were calculated for each gene and subregion. Results: 479 travellers were analysed. 21.8% acquired aggR (EAEC), with highest acquisition rates in Northern and Western Africa and 15.3% acquired eae (STEC/EPEC) with highest rates in travellers to Western and Eastern Africa. ETEC (elt or est gene) was acquired by 4.2% of travellers and acquisition of est was associated with traveller's diarrhoea. Overall, the risk of acquiring DEC VGs was low in Southern Africa and South America. Although the combination of aggR (EAEC) and stx1/2 (STEC) was acquired by 3 travellers, these genes could not be detected together in a single E. coli strain. Conclusions: The risk of acquisition of DEC VGs strongly depends on the travel destination, with those travelling to Africa - except Southern Africa - having a higher risk.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85060351339&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/30609386

U2 - 10.1016/j.tmaid.2018.12.005

DO - 10.1016/j.tmaid.2018.12.005

M3 - Article

JO - Travel Medicine and Infectious Disease

JF - Travel Medicine and Infectious Disease

SN - 1477-8939

ER -