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Table 1 Study characteristics of the 22 included studies

From: Acquisition of multidrug-resistant Enterobacterales during international travel: a systematic review of clinical and microbiological characteristics and meta-analyses of risk factors

StudyYearCountryStudy periodPopulation characteristicStudy sizeaProportion of MDR E. colie in post-travel isolatesSample time (range) before/after travelMedian duration of travel in days (range)Follow-up of carriage
Kennedy [21]2010AustraliaJanuary 2008–April 2009Hospital staff and contacts102> 92% E. colibWithin 2 weeks before and after21 (9–135)6 months
Tängdén [12]2010SwedenNovember 2007–January 2009Travel clinic100100% E. coli (24/24b)Unknown14 (7–182)6 months
Weisenberg [22]2012United StatesJuly 2009–February 2010Travel clinic28E. coli 100% (7/7b)1 week before/within 1 week after14 (8–42)None
Östholm-Balkhed* [23, 24]2013SwedenSeptember 2008–April 2009Vaccination clinic23190% E. coli (104/116)b15 (1–114) days/ 3 (0–191) days16 (4–119)12 months
Paltansing* [25]2013The NetherlandsMarch 2011–September 2011Travel clinic37092% E. coli (146/158)cImmediately before and after21 (6–90)6 months
Kuenzli* [26]2014SwitzerlandDecember 2012–October 2013Travel clinic19098% E. coli (157/161b)Week before/directly afterMean; 18 (5–35)None
von Wintersdorff [27]2014The NetherlandsNovember 2010–August 2012Travel clinic122NDBefore and immediately after21 (5–240)None
Angelin* [28]2015SwedenApril 2010–January 2014Healthcare students99100% E. coli (35/35c)Close to departure/ 1–2 weeks after return45 (13–365)None
Kantele* [29]2015FinlandMarch 2009–February 2010Travel clinic43097% E. coli (94/97b)Before/first (or second) stool afterMean; 19 (4–133)12 months
Lübbert [30]2015GermanyMay 2013–April 2014Travel clinic20592% E. coli (58/63b)Before/within 1 week after21 (2–218)6 months
Ruppé* [31]2015FranceFebruary 2012–April 2013Vaccination centers57493% E. coli (491/526b)Within 1 week before and after20 (IQR 15–30)12 months
Bernasconi [32]2016SwitzerlandJanuary 2015–August 2015Unknown3890% E. coli (26/29b)Within 1 week before and afterMean; 15 (8–35)6 months
Mizuno [33]2016JapanSeptember 2012–March 2015Business travelers57NDBefore and at time of return> 6 monthsNone
Reuland* [34]2016The NetherlandsApril 2012–April 2013Vaccination clinic44597% E. coli (95/98b)Before/within 2 weeks afterMean; 14 (1–105)None
Vading* [35]2016SwedenApril 2013–May 2015Travel clinic18897% E. coli (65/67b)Unknown14 (IQR 8–20)10 to 26 months
van Hattemd [36]2016The NetherlandsNovember 2012–November 2013Travel clinic200160% E. coli (3/5b)Before/immediately and 1 month after travel20 (IQR 15–25)12 months
Arcilla*d [37]2017The NetherlandsNovember 2012–November 2013Travel clinic200188% E. coli (759/859b)Before/immediately and 1 month after travel20 (IQR 15–25)12 months
Leangapichart* [38]2017FranceHajj 2013 & 2014Hajj pilgrims218NDJust before departure and after the Hajj just before return22 and 24None
Peirano* [39]2017CanadaJanuary 2012–July 2014Travel clinic116100% E. coli (124/124b)Before /within 1 week after10–386 months
Bevan [40]2018United KingdomMarch 2015–June 2016University and university hospital18100% E. coli (16/16)As close to the time of sample submission and after21, mean 27Up to 12 months
Nakayama [41]2018JapanJune 2015–August 2016Unknown19100% E. coliBefore and up to 2 weeks after2–12 daysNone
Schaumburg* [42]2019Germany/the NetherlandsOctober 2016–March 2018Vaccination center132ESBL-producing EnterobacteralesUp to 1 week before departure, during travel and up to 1 week after returnMean: 18.7, maximum of six weeks6 months (137–420 days after return)
  1. Abbreviations: E. coli, Escherichia coli; MDR Multidrug-resistant; ND No data; *, included in the meta-analyses
  2. a Number of travelers who provided pre-travel and post-travel samples
  3. b MDR microorganisms newly acquired during travel
  4. c Data about post-travel samples
  5. d Reported on the same study population, however, van Hattem et al. reported on CPE acquisition, and Arcilla et al. on ESBL-E acquisition
  6. e Including ESBL-producing E. coli and carbapenemase-producing E. coli