The Carriage of Multiresistant Bacteria After Travel (COMBAT) prospective cohort study: methodology and design

M.S. Arcilla; J.M. van Hattem; M.C.J. Bootsma; P.J. van Genderen; A. Goorhuis; C. Schultsz; E.E. Stobberingh; H.A. Verbrugh; M.D. de Jong; D.C, Melles; J. Penders

doi:10.1186/1471-2458-14-410

The Carriage of Multiresistant Bacteria After Travel (COMBAT) prospective cohort study: methodology and design

M.S. Arcilla, J.M. van Hattem, M.C.J. Bootsma, P.J. van Genderen, A. Goorhuis, C. Schultsz, E.E. Stobberingh, H.A. Verbrugh, M.D. de Jong, D.C, Melles, J. Penders^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: Antimicrobial resistance (AMR) is one of the major threats to public health around the world. Besides the intense use and misuse of antimicrobial agents as the major force behind the increase in antimicrobial resistance, the exponential increase of international travel may also substantially contribute to the emergence and spread of AMR. However, knowledge on the extent to which international travel contributes to this is still limited. The Carriage Of Multiresistant Bacteria After Travel (COMBAT) study aims to 1. determine the acquisition rate of multiresistant Enterobacteriaceae during foreign travel 2. ascertain the duration of carriage of these micro-organisms 3. determine the transmission rate within households 4. identify risk factors for acquisition, persistence of carriage and transmission of multiresistant Enterobacteriaceae. Methods/design: The COMBAT-study is a large-scale multicenter longitudinal cohort study among travellers (n = 2001) and their non-travelling household members (n = 215). Faecal samples are collected before and immediately after travel and 1 month after return from all participants. Follow-up faecal samples are collected 3, 6 and 12 months after return from travellers (and their non-travelling household members) who acquired multiresistant Enterobacteriaceae. Questionnaires are collected from all participants at each time-point. Faecal samples are screened phenotypically for the presence of extended-spectrum beta-lactamase (ESBL) or carbapenemase-producing Enterobacteriaceae. Positive post-travel isolates from travellers with negative pre-travel samples are genotypically analysed for ESBL and carbapenemase genes with microarray and gene sequencing. Discussion: The design and scale of the COMBAT-study will enable us to provide much needed detailed insights into the risks and dynamics of introduction and spread of ESBL-and carbapenemase-producing Enterobacteriaceae by healthy travellers and the potential need and measures to monitor or manage these risks.

Original language	English
Article number	410
Journal	BMC Public Health
Volume	14
DOIs	https://doi.org/10.1186/1471-2458-14-410
Publication status	Published - 1 Jan 2014

Access to Document

10.1186/1471-2458-14-410Licence: CC BY

Cite this

Arcilla, M. S., van Hattem, J. M., Bootsma, M. C. J., van Genderen, P. J., Goorhuis, A., Schultsz, C., Stobberingh, E. E., Verbrugh, H. A., de Jong, M. D., Melles, D. C., & Penders, J. (2014). The Carriage of Multiresistant Bacteria After Travel (COMBAT) prospective cohort study: methodology and design. BMC Public Health, 14, Article 410. https://doi.org/10.1186/1471-2458-14-410

@article{9392fa547c194fb7aafddcb09e32cdcf,

title = "The Carriage of Multiresistant Bacteria After Travel (COMBAT) prospective cohort study: methodology and design",

abstract = "Background: Antimicrobial resistance (AMR) is one of the major threats to public health around the world. Besides the intense use and misuse of antimicrobial agents as the major force behind the increase in antimicrobial resistance, the exponential increase of international travel may also substantially contribute to the emergence and spread of AMR. However, knowledge on the extent to which international travel contributes to this is still limited. The Carriage Of Multiresistant Bacteria After Travel (COMBAT) study aims to 1. determine the acquisition rate of multiresistant Enterobacteriaceae during foreign travel 2. ascertain the duration of carriage of these micro-organisms 3. determine the transmission rate within households 4. identify risk factors for acquisition, persistence of carriage and transmission of multiresistant Enterobacteriaceae. Methods/design: The COMBAT-study is a large-scale multicenter longitudinal cohort study among travellers (n = 2001) and their non-travelling household members (n = 215). Faecal samples are collected before and immediately after travel and 1 month after return from all participants. Follow-up faecal samples are collected 3, 6 and 12 months after return from travellers (and their non-travelling household members) who acquired multiresistant Enterobacteriaceae. Questionnaires are collected from all participants at each time-point. Faecal samples are screened phenotypically for the presence of extended-spectrum beta-lactamase (ESBL) or carbapenemase-producing Enterobacteriaceae. Positive post-travel isolates from travellers with negative pre-travel samples are genotypically analysed for ESBL and carbapenemase genes with microarray and gene sequencing. Discussion: The design and scale of the COMBAT-study will enable us to provide much needed detailed insights into the risks and dynamics of introduction and spread of ESBL-and carbapenemase-producing Enterobacteriaceae by healthy travellers and the potential need and measures to monitor or manage these risks.",

author = "M.S. Arcilla and {van Hattem}, J.M. and M.C.J. Bootsma and {van Genderen}, P.J. and A. Goorhuis and C. Schultsz and E.E. Stobberingh and H.A. Verbrugh and {de Jong}, M.D. and D.C, Melles and J. Penders",

year = "2014",

month = jan,

day = "1",

doi = "10.1186/1471-2458-14-410",

language = "English",

volume = "14",

journal = "BMC Public Health",

issn = "1471-2458",

publisher = "BioMed Central Ltd",

}

TY - JOUR

T1 - The Carriage of Multiresistant Bacteria After Travel (COMBAT) prospective cohort study: methodology and design

AU - Arcilla, M.S.

AU - van Hattem, J.M.

AU - Bootsma, M.C.J.

AU - van Genderen, P.J.

AU - Goorhuis, A.

AU - Schultsz, C.

AU - Stobberingh, E.E.

AU - Verbrugh, H.A.

AU - de Jong, M.D.

AU - Melles, D.C,

AU - Penders, J.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background: Antimicrobial resistance (AMR) is one of the major threats to public health around the world. Besides the intense use and misuse of antimicrobial agents as the major force behind the increase in antimicrobial resistance, the exponential increase of international travel may also substantially contribute to the emergence and spread of AMR. However, knowledge on the extent to which international travel contributes to this is still limited. The Carriage Of Multiresistant Bacteria After Travel (COMBAT) study aims to 1. determine the acquisition rate of multiresistant Enterobacteriaceae during foreign travel 2. ascertain the duration of carriage of these micro-organisms 3. determine the transmission rate within households 4. identify risk factors for acquisition, persistence of carriage and transmission of multiresistant Enterobacteriaceae. Methods/design: The COMBAT-study is a large-scale multicenter longitudinal cohort study among travellers (n = 2001) and their non-travelling household members (n = 215). Faecal samples are collected before and immediately after travel and 1 month after return from all participants. Follow-up faecal samples are collected 3, 6 and 12 months after return from travellers (and their non-travelling household members) who acquired multiresistant Enterobacteriaceae. Questionnaires are collected from all participants at each time-point. Faecal samples are screened phenotypically for the presence of extended-spectrum beta-lactamase (ESBL) or carbapenemase-producing Enterobacteriaceae. Positive post-travel isolates from travellers with negative pre-travel samples are genotypically analysed for ESBL and carbapenemase genes with microarray and gene sequencing. Discussion: The design and scale of the COMBAT-study will enable us to provide much needed detailed insights into the risks and dynamics of introduction and spread of ESBL-and carbapenemase-producing Enterobacteriaceae by healthy travellers and the potential need and measures to monitor or manage these risks.

AB - Background: Antimicrobial resistance (AMR) is one of the major threats to public health around the world. Besides the intense use and misuse of antimicrobial agents as the major force behind the increase in antimicrobial resistance, the exponential increase of international travel may also substantially contribute to the emergence and spread of AMR. However, knowledge on the extent to which international travel contributes to this is still limited. The Carriage Of Multiresistant Bacteria After Travel (COMBAT) study aims to 1. determine the acquisition rate of multiresistant Enterobacteriaceae during foreign travel 2. ascertain the duration of carriage of these micro-organisms 3. determine the transmission rate within households 4. identify risk factors for acquisition, persistence of carriage and transmission of multiresistant Enterobacteriaceae. Methods/design: The COMBAT-study is a large-scale multicenter longitudinal cohort study among travellers (n = 2001) and their non-travelling household members (n = 215). Faecal samples are collected before and immediately after travel and 1 month after return from all participants. Follow-up faecal samples are collected 3, 6 and 12 months after return from travellers (and their non-travelling household members) who acquired multiresistant Enterobacteriaceae. Questionnaires are collected from all participants at each time-point. Faecal samples are screened phenotypically for the presence of extended-spectrum beta-lactamase (ESBL) or carbapenemase-producing Enterobacteriaceae. Positive post-travel isolates from travellers with negative pre-travel samples are genotypically analysed for ESBL and carbapenemase genes with microarray and gene sequencing. Discussion: The design and scale of the COMBAT-study will enable us to provide much needed detailed insights into the risks and dynamics of introduction and spread of ESBL-and carbapenemase-producing Enterobacteriaceae by healthy travellers and the potential need and measures to monitor or manage these risks.

U2 - 10.1186/1471-2458-14-410

DO - 10.1186/1471-2458-14-410

M3 - Article

C2 - 24775515

SN - 1471-2458

VL - 14

JO - BMC Public Health

JF - BMC Public Health

M1 - 410

ER -