Due to increasing colistin usage, the dissemination of the colistin-resistant genemcr-1has been increasingly investigated. The aim of this study was to determine whether a traveler on a short-term international trip to a developing country could bringmcr-1back to their home country.
Thirty-four travel events from Japan to Vietnam encompassing 19 travelers were assessed. A fecal specimen was collected from each traveler before and after each travel event and was inoculated on CHROMagar containing cefotaxime (CTX). Three to seven colonies exhibiting the characteristics ofEscherichia coliwere collected. Susceptibility to antibiotics and extended-spectrum β-lactamase (ESBL) production were determined by the disk diffusion method and the double-disk synergy test, respectively. ESBL-encoding genes were genotyped, and phylogenetic groupings were determined by multiplex polymerase chain reaction (PCR). The presence ofmcr-1was also confirmed by PCR and sequencing.
A total of 175 ESBL-producingE. coliisolated before and up to 2 weeks after traveling to Vietnam were analyzed. Genotyping of ESBL-producing isolates showed thatblaCTX-M-1/blaTEM(27.7%) andblaCTX-M-9(45.9%) were the most prevalent genotypes, while the most frequently detected phylogenetic group was D (41.9%) followed by B2 (23.0%). In a significant number of travel events, travelers brought ESBL-producingE. coliback to Japan and three events by three travelers carriedmcr-1. ESBL-producingE. coliisolates harboringmcr-1were identified as those carrying bothblaCTX-M-14orblaCTX-M-55andmcr-1.
Using Vietnam as an example, we have shown that even a short-term trip to some countries may result in ESBL-producingmcr-1-positiveE. colicarriage by international travelers.