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. 2019 Jul;25(7):1380–1383. doi: 10.3201/eid2507.181492

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Microbiome and AMR gene dynamics in international travelers. A) Longitudinal profile of traveler gut microbiome diversity measured by Shannon diversity Index. Traveler 5 (T5) had a Shannon diversity index >3 SDs below the mean when measured at 30 days and 6 months posttravel. B) Microbes, by genus, demonstrating the greatest fold change in abundance after travel on the basis of DNA sequencing nucleotide alignments. C) Total number of AMR genes identified with >20% allele coverage by DNA sequencing. D) Total number of AMR genes identified with >20% allele coverage by RNA sequencing. AGLY, aminoglycoside; AMR, antimicrobial resistance; BLA, β-lactamase; FLQ, fluoroquinolone; MLS, macrolide, lincosamide, streptogramin; PRE, pretravel (within 1 week before departure); PST, posttravel (within 1 week after return); TMP/SUL, trimethoprim/sulfamethoxazole; TET, tetracycline; ESBL, extended-spectrum β-lactamase.