Table 1.
Study characteristics of the 22 included studies
| Study | Year | Country | Study period | Population characteristic | Study sizea | Proportion of MDR E. colie in post-travel isolates | Sample time (range) before/after travel | Median duration of travel in days (range) | Follow-up of carriage |
|---|---|---|---|---|---|---|---|---|---|
| Kennedy [21] | 2010 | Australia | January 2008–April 2009 | Hospital staff and contacts | 102 | > 92% E. colib | Within 2 weeks before and after | 21 (9–135) | 6 months |
| Tängdén [12] | 2010 | Sweden | November 2007–January 2009 | Travel clinic | 100 | 100% E. coli (24/24b) | Unknown | 14 (7–182) | 6 months |
| Weisenberg [22] | 2012 | United States | July 2009–February 2010 | Travel clinic | 28 | E. coli 100% (7/7b) | 1 week before/within 1 week after | 14 (8–42) | None |
| Östholm-Balkhed* [23, 24] | 2013 | Sweden | September 2008–April 2009 | Vaccination clinic | 231 | 90% E. coli (104/116)b | 15 (1–114) days/ 3 (0–191) days | 16 (4–119) | 12 months |
| Paltansing* [25] | 2013 | The Netherlands | March 2011–September 2011 | Travel clinic | 370 | 92% E. coli (146/158)c | Immediately before and after | 21 (6–90) | 6 months |
| Kuenzli* [26] | 2014 | Switzerland | December 2012–October 2013 | Travel clinic | 190 | 98% E. coli (157/161b) | Week before/directly after | Mean; 18 (5–35) | None |
| von Wintersdorff [27] | 2014 | The Netherlands | November 2010–August 2012 | Travel clinic | 122 | ND | Before and immediately after | 21 (5–240) | None |
| Angelin* [28] | 2015 | Sweden | April 2010–January 2014 | Healthcare students | 99 | 100% E. coli (35/35c) | Close to departure/ 1–2 weeks after return | 45 (13–365) | None |
| Kantele* [29] | 2015 | Finland | March 2009–February 2010 | Travel clinic | 430 | 97% E. coli (94/97b) | Before/first (or second) stool after | Mean; 19 (4–133) | 12 months |
| Lübbert [30] | 2015 | Germany | May 2013–April 2014 | Travel clinic | 205 | 92% E. coli (58/63b) | Before/within 1 week after | 21 (2–218) | 6 months |
| Ruppé* [31] | 2015 | France | February 2012–April 2013 | Vaccination centers | 574 | 93% E. coli (491/526b) | Within 1 week before and after | 20 (IQR 15–30) | 12 months |
| Bernasconi [32] | 2016 | Switzerland | January 2015–August 2015 | Unknown | 38 | 90% E. coli (26/29b) | Within 1 week before and after | Mean; 15 (8–35) | 6 months |
| Mizuno [33] | 2016 | Japan | September 2012–March 2015 | Business travelers | 57 | ND | Before and at time of return | > 6 months | None |
| Reuland* [34] | 2016 | The Netherlands | April 2012–April 2013 | Vaccination clinic | 445 | 97% E. coli (95/98b) | Before/within 2 weeks after | Mean; 14 (1–105) | None |
| Vading* [35] | 2016 | Sweden | April 2013–May 2015 | Travel clinic | 188 | 97% E. coli (65/67b) | Unknown | 14 (IQR 8–20) | 10 to 26 months |
| van Hattemd [36] | 2016 | The Netherlands | November 2012–November 2013 | Travel clinic | 2001 | 60% E. coli (3/5b) | Before/immediately and 1 month after travel | 20 (IQR 15–25) | 12 months |
| Arcilla*d [37] | 2017 | The Netherlands | November 2012–November 2013 | Travel clinic | 2001 | 88% E. coli (759/859b) | Before/immediately and 1 month after travel | 20 (IQR 15–25) | 12 months |
| Leangapichart* [38] | 2017 | France | Hajj 2013 & 2014 | Hajj pilgrims | 218 | ND | Just before departure and after the Hajj just before return | 22 and 24 | None |
| Peirano* [39] | 2017 | Canada | January 2012–July 2014 | Travel clinic | 116 | 100% E. coli (124/124b) | Before /within 1 week after | 10–38 | 6 months |
| Bevan [40] | 2018 | United Kingdom | March 2015–June 2016 | University and university hospital | 18 | 100% E. coli (16/16) | As close to the time of sample submission and after | 21, mean 27 | Up to 12 months |
| Nakayama [41] | 2018 | Japan | June 2015–August 2016 | Unknown | 19 | 100% E. coli | Before and up to 2 weeks after | 2–12 days | None |
| Schaumburg* [42] | 2019 | Germany/the Netherlands | October 2016–March 2018 | Vaccination center | 132 | ESBL-producing Enterobacterales | Up to 1 week before departure, during travel and up to 1 week after return | Mean: 18.7, maximum of six weeks | 6 months (137–420 days after return) |
Abbreviations: E. coli, Escherichia coli; MDR Multidrug-resistant; ND No data; *, included in the meta-analyses
a Number of travelers who provided pre-travel and post-travel samples
b MDR microorganisms newly acquired during travel
c Data about post-travel samples
d Reported on the same study population, however, van Hattem et al. reported on CPE acquisition, and Arcilla et al. on ESBL-E acquisition
e Including ESBL-producing E. coli and carbapenemase-producing E. coli