{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T23:00:44Z","timestamp":1784070044196,"version":"3.55.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2022,3,2]],"date-time":"2022-03-02T00:00:00Z","timestamp":1646179200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Finnish Association of Infectious diseases"},{"name":"The Sigrid Jus\u00e9lius Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>As hospitals have a high prevalence of multidrug-resistant organisms (MDRO), hospitalization abroad indicates for travellers an increased risk of acquiring MDRO\u2014and carrying the strains home. Antimicrobial resistance (AMR) rates are highest in the (sub)tropics, whereas Europe is considered a lower risk region. Since AMR prevalences vary within Europe, we aimed to gather country-specific data on the risks for hospitalized travellers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>At hospitals of the Helsinki and Uusimaa district in Finland, patients hospitalized abroad over the past 12\u00a0months are systematically screened for methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales (ESBL-PE), carbapenemase-producing bacteria and vancomycin-resistant Enterococcus spp. (VRE). Among patients screened 2010\u201319, we selected those hospitalized in Europe, recorded their MDRO findings, infections and mortality, and analysed MDRO-associated risk factors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 1772 patients treated in 41 European countries, 16.6% (295) carried MDRO, 12.5% (221) ESBL-PE, 7.8% (138) solely ESBL-E. coli, 2.6% (46) MRSA, 2.2% (30) of those screened VRE and 2.2% (39) carbapenem-resistant Gram-negatives. Among those colonized, 9.8% (29) had symptomatic MDRO infections and 0.3% (one) died. Colonization was most frequently recorded for those treated in eastern and southern Europe, with Bulgaria, Cyprus and the Russian Federation scoring highest. MDRO colonization was associated with antibiotic treatment and showed a negative correlation with time from discharge to screening.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>After hospitalization in European countries, ESBL-PE carriage was relatively common (12.5%), while other MDROs proved less frequent (&amp;lt;5%). Antibiotic treatment and short time since hospitalization abroad increased the risk of MDRO colonization. Clear differences between countries and regions were revealed, with highest rates in the east and the south.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jtm\/taac022","type":"journal-article","created":{"date-parts":[[2022,3,2]],"date-time":"2022-03-02T12:07:44Z","timestamp":1646222864000},"source":"Crossref","is-referenced-by-count":22,"title":["European hospitals as source of multidrug-resistant bacteria: analysis of travellers screened in Finland after hospitalization abroad"],"prefix":"10.1093","volume":"29","author":[{"given":"Mikael","family":"Kajova","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases , Inflammation Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"},{"name":"Meilahti Infectious Diseases and Vaccine Research Center , MeiVac, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"},{"name":"Multidisciplinary Center of Excellence in Antimicrobial Resistance Research , University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamim","family":"Khawaja","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases , Inflammation Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"},{"name":"Meilahti Infectious Diseases and Vaccine Research Center , MeiVac, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"},{"name":"Multidisciplinary Center of Excellence in Antimicrobial Resistance Research , University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anu","family":"Kantele","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases , Inflammation Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"},{"name":"Meilahti Infectious Diseases and Vaccine Research Center , MeiVac, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"},{"name":"Multidisciplinary Center of Excellence in Antimicrobial Resistance Research , University of Helsinki, Helsinki, Finland"},{"name":"Human Microbiome Research Program , Faculty of Medicine, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,3,2]]},"reference":[{"key":"2022071415392706600_ref1","doi-asserted-by":"crossref","DOI":"10.1093\/jtm\/taz036","article-title":"Global geographic trends in antimicrobial resistance: the role of international travel","volume":"26","author":"Frost","year":"2019","journal-title":"J Travel Med"},{"key":"2022071415392706600_ref2","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1111\/jtm.12220","article-title":"Risk factors for colonization with multidrug-resistant bacteria among patients admitted to the intensive care unit after returning from abroad","volume":"22","author":"Angue","year":"2015","journal-title":"J 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