[Source: PLOS One, full page: (LINK). Abstract, edited.]
OPEN ACCESS / PEER-REVIEWED / RESEARCH ARTICLE
Quinolone nonsusceptibility among enteric pathogens isolated from international travelers – Foodborne Diseases Active Surveillance Network (FoodNet) and National Antimicrobial Monitoring System (NARMS), 10 United States sites, 2004 – 2014
Julian E. Grass , Sunkyung Kim, Jennifer Y. Huang, Stephanie M. Morrison, Andre E. McCullough, Christy Bennett, Cindy R. Friedman, Anna Bowen
Published: December 4, 2019 / DOI: https://doi.org/10.1371/journal.pone.0225800
Gastrointestinal illnesses are the most frequently diagnosed conditions among returning U.S. travelers. Although most episodes of travelers’ diarrhea do not require antibiotic therapy, fluoroquinolones (a type of quinolone antibiotic) are recommended for treatment of moderate and severe travelers’ diarrhea as well as many other types of severe infection. To assess associations between quinolone susceptibility and international travel, we linked data about isolate susceptibility in NARMS to cases of enteric infections reported to FoodNet. We categorized isolates as quinolone-nonsusceptible (QNS) if they were resistant or had intermediate susceptibility to ≥1 quinolone. Among 1,726 travel-associated infections reported to FoodNet with antimicrobial susceptibility data in NARMS during 2004–2014, 56% of isolates were quinolone-nonsusceptible, of which most (904/960) were Campylobacter. International travel was associated with >10-fold increased odds of infection with quinolone-nonsusceptible bacteria. Most QNS infections were associated with travel to Latin America and the Caribbean (390/743; 52%); however, the greatest risk of QNS infection was associated with travel to Africa (120 per 1,000,000 passenger journeys). Preventing acquisition and onward transmission of antimicrobial-resistant enteric infections among travelers is critical.
Citation: Grass JE, Kim S, Huang JY, Morrison SM, McCullough AE, Bennett C, et al. (2019) Quinolone nonsusceptibility among enteric pathogens isolated from international travelers – Foodborne Diseases Active Surveillance Network (FoodNet) and National Antimicrobial Monitoring System (NARMS), 10 United States sites, 2004 – 2014. PLoS ONE 14(12): e0225800. https://doi.org/10.1371/journal.pone.0225800
Editor: Adriano Gianmaria Duse, School of Pathology, National Health Laboratory Service (NHLS) and University of the Witwatersrand, South Africa, SOUTH AFRICA
Received: June 25, 2019; Accepted: November 12, 2019; Published: December 4, 2019
This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
Data Availability: All relevant data are within the manuscript and its Supporting Information files.
Funding: The author(s) received no specific funding for this work.
Competing interests: The authors have declared that no competing interests exist.
Keywords: Antibiotics; Drugs Resistance; Quinolones; Travelers; USA.