Table 2.
Characteristics associated with acquisition of ESBL-producing Enterobacteriaceae
| Characteristic | ESBL (n = 8) | No ESBL (n = 64) | P-value |
|---|---|---|---|
| Gender | |||
| Male | 6 (75 [34.9–96.8%]) | 51 (80 [67.2–88.7%]) | 0.67 |
| Female | 2 (25 [3.2–65.1%]) | 13 (20 [11.3–32.8%]) | 0.67 |
| Median age (years) | 39.5 (IQR 32.25, 46.0) | 41.5 (IQR 34.0, 49.0) | 0.53 |
| Median duration of travel (days) | 17.0 (IQR 7.5, 154.0) | 17.0 (IQR 8.0, 24.0) | 0.75 |
| Region of travel | |||
| Mexico, Caribbean and Central America | 0 (0 [0–36.9%]) | 12 (18.8 [11.1–30.5%]) | 0.34 |
| Asia* | 4 (50 [15.7–84.3%]) | 7 (10.9 [4.9–21.2%]) | 0.02 |
| Africa | 3 (37.5 [8.5–75.5%]) | 38 (59.4 [46.4–71.5%]) | 0.28 |
| South America | 1 (12.5 [0.3–52.7%]) | 6 (9.4 [3.5–19.3%]) | 0.58 |
| Living conditions | |||
| Hotel with air conditioning | 4 (50 [15.7–84.3%]) | 28 (43.8 [31.4–56.7%]) | 1.00 |
| Hotel without air conditioning | 1 (12.5 [0.3–52.7%]) | 7 (10.9 [4.5–21.2%]) | 1.00 |
| Military accommodations | 0 (0 [0–36.9%]) | 4 (6.3 [1.7–15.2%]) | 1.00 |
| Dormitories/Barracks | 3 (37.5 [8.5–75.5%]) | 33 (51.6 [38.7–64.2%]) | 0.71 |
| Food exposures | |||
| Food from street vendors | 2 (25 [3.2–65.1%]) | 13 (20 [11.3–32.8%]) | 0.67 |
| Meals prepared at local homes | 1 (12.5 [0.3–52.7%]) | 15 (23.4 [13.8–35.7%]) | 0.67 |
| Unpasteurized dairy products | 0 (0 [0–36.9%]) | 2 (3.1 [0.4–10.8%]) | 1.00 |
| Poorly cooked or raw meat/seafood | 1 (12.5 [0.3–52.7%]) | 6 (9.4 [3.5–19.3%]) | 0.58 |
| Poorly cooked or raw vegetables/salad | 2 (25 [3.2–65.1%]) | 7 (10.9 [4.9–21.2%]) | 0.26 |
| Field water exposure | 0 (0 [0–36.9%]) | 5 (7 [2.6–17.3%]) | 1.00 |
| Local water ingestion | |||
| Untreated water | 0 (0 [0–36.9%]) | 1 (1.6 [0–8.4%]) | 1.00 |
| Ice in beverage | 3 (37.5 [8.5–75.5%]) | 28 (43.8 [31.4–56.7%]) | 1.00 |
| None of the above food or water exposures | 1 (12.5 [0.3–52.7%]) | 19 (29.7 [18.9–42.4%]) | 0.43 |
| Unable to wash hands regularly before eating | 1 (12.5 [0.3–52.7%]) | 11 (17.2 [8.9–28.7%]) | 1.00 |
| Antimicrobial exposure since enrollment | 6 (75 [34.9–96.8%]) | 52 (81.2 [69.5–89.9%) | 0.65 |
| Malaria prophylaxis | 6 (75 [34.9–96.8%]) | 51 (80 [67.2–88.7%]) | 0.67 |
| Chloroquine | 0 (0 [0–36.9%]) | 2 (3.1 [0.4–10.8%]) | 1.00 |
| Mefloquine | 0 (0 [0–36.9%]) | 0 (0 [0–5.6%]) | n/a |
| Atovaquone–proguanil | 4 (50 [15.7–84.3%]) | 41 (64.1 [51.5–75.7%]) | 0.46 |
| Doxycycline | 2 (25 [3.2–65.1%]) | 9 (14.1 [6.6–25.0%]) | 0.60 |
| Primaquine | 3 (37.5 [8.5–75.5%]) | 6 (9.4 [3.5–19.3%]) | 0.06 |
| Antibiotics for TD | 2 (25 [3.2–65.1%]) | 6 (9.4 [3.5–19.3%]) | 0.22 |
| Ciprofloxacin | 1 (12.5 [0.3–52.7%]) | 3 (4.7 [1–13.1%]) | 0.33 |
| Azithromycin | 1 (12.5 [0.3–52.7%]) | 2 (3.1 [0.4–10.8%]) | 0.20 |
| Levofloxacin | 0 (0 [0–36.9%]) | 1 (1.6 [0–8.4%]) | n/a |
| Systemic antibiotics for other reason | 0 (0 [0–36.9%]) | 3 (4.7 [1.0–13.1%]) | 1.00 |
| Amoxicillin/clavulanate | 0 (0 [0–36.9%]) | 1 (1.6 [0–8.4%]) | n/a |
| Levofloxacin | 0 (0 [0–36.9%]) | 1 (1.6 [0–8.4%]) | n/a |
| Sulfamethoxazole/trimethoprim | 0 (0% [0–36.9]) | 1 (1.6 [0–8.4%]) | n/a |
| Illness since enrollment | 3 (37.5 [8.5–75.5%]) | 16 (25 [15.0–37.4%]) | 0.43 |
| Fever | 0 (0 [0–36.9%]) | 0 (0–5.6%) | n/a |
| Influenza-like illness | 1 (12.5 [0.3–52.7%]) | 8 (12.5 [0.3–52.7%]) | 1.00 |
| TD | 2 (25 [3.2–65.1%]) | 8 (12.5 [5.6–23.2%]) | 0.31 |
*Isolates were from India and Afghanistan.
ESBL, extended spectrum beta-lactamase; all ESBL-producing Enterobacteriaceae were E. coli.