{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T04:14:34Z","timestamp":1775276074397,"version":"3.50.1"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:00:00Z","timestamp":1614643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Infectious Disease Clinical Research Program","award":["IDCRP-037"],"award-info":[{"award-number":["IDCRP-037"]}]},{"DOI":"10.13039\/100007188","name":"Uniformed Services University of the Health Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007188","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100003896","name":"Henry M. Jackson Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100003896","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Advancement of Military Medicine, Inc."},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["Y1-Al-5072"],"award-info":[{"award-number":["Y1-Al-5072"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Department of Defense Global Emerging Infections Surveillance"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>International travel is a risk factor for incident colonization with extended spectrum beta-lactamase (ESBL)-producing organisms. These and other multidrug-resistant (MDR) bacteria are major pathogens in combat casualties. We evaluated risk factors for colonization with MDR bacteria in US military personnel travelling internationally for official duty.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>TravMil is a prospective observational study enrolling subjects presenting to military travel clinics. We analysed surveys, antimicrobial use data, and pre- and post-travel perirectal swabs in military travellers to regions outside the continental USA, Canada, Western or Northern Europe, or New Zealand, presenting to one clinic from 12\/2015 to 12\/2017. Recovered Gram-negative isolates underwent identification and susceptibility testing (BD Phoenix). Characteristics of trip and traveller were analysed to determine risk factors for MDR organism colonization.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>110 trips were planned by 99 travellers (74% male, median age 38\u00a0years [IQR 31, 47.25]); 72 trips with returned pre- and post-travel swabs were completed by 64 travellers. Median duration was 21\u00a0days (IQR 12.75, 79.5). 17% travelled to Mexico\/Caribbean\/Central America, 15% to Asia, 57% to Africa and 10% to South America; 56% stayed in hotels and 50% in dormitories\/barracks. Travellers used doxycycline (15%) for malaria prophylaxis, 11% took an antibiotic for travellers\u2019 diarrhoea (TD) treatment (fluoroquinolone 7%, azithromycin 4%). Incident MDR organism colonization occurred in 8 travellers (incidence density 3.5\/1000 travel days; cumulative incidence 11% of trips [95% CI: 4\u201319%]), all ESBL-producing Escherichia coli. A higher incidence of ESBL-producing E. coli acquisition was associated with travel to Asia (36% vs 7%, P\u2009=\u20090.02) but not with travel to other regions, TD or use of antimicrobials. No relationship was seen between fluoroquinolone or doxycycline exposure and resistance to those antimicrobials.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Incident colonization with MDR organisms occurs at a lower rate in this military population compared with civilian travellers, with no identified modifiable risk factors, with highest incidence of ESBL acquisition observed after South Asia travel.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jtm\/taab028","type":"journal-article","created":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T20:11:31Z","timestamp":1614197491000},"source":"Crossref","is-referenced-by-count":12,"title":["Travel-associated multidrug-resistant organism acquisition and risk factors among US military personnel"],"prefix":"10.1093","volume":"28","author":[{"given":"Gregory","family":"Buchek","sequence":"first","affiliation":[{"name":"Brooke Army Medical Center, JBSA Fort Sam Houston, TX, USA"},{"name":"Uniformed Services University of the Health Sciences, Bethesda, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrin","family":"Mende","sequence":"additional","affiliation":[{"name":"Brooke Army Medical Center, JBSA Fort Sam Houston, TX, USA"},{"name":"Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA"},{"name":"Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kalyani","family":"Telu","sequence":"additional","affiliation":[{"name":"Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA"},{"name":"Henry M Jackson Foundation for the Advancement of Military Medicine, 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USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Indrani","family":"Mitra","sequence":"additional","affiliation":[{"name":"Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA"},{"name":"Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Stam","sequence":"additional","affiliation":[{"name":"Walter Reed Army Institute of Research, Silver Spring, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tahaniyat","family":"Lalani","sequence":"additional","affiliation":[{"name":"Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA"},{"name":"Henry M Jackson Foundation for the Advancement of Military 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