{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:26:19Z","timestamp":1787009179673,"version":"build-2736575974"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T00:00:00Z","timestamp":1677715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004853","name":"The Chinese University of Hong Kong","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004853","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005847","name":"Health and Medical Research Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005847","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Food and Health Bureau of the Hong Kong Special Administrative Region, China","award":["18170082"],"award-info":[{"award-number":["18170082"]}]},{"name":"Food and Health Bureau of the Hong Kong Special Administrative Region, China","award":["18170312"],"award-info":[{"award-number":["18170312"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>International travel increases the risk of acquisition of antibiotic-resistant bacteria and antibiotic resistance genes (ARGs). Previous studies have characterized the changes in the gut microbiome and resistome of Western travellers; however, information on non-Western populations and the effects of travel-related risk factors on the gut microbiome and resistome remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective observational study on a cohort of 90 healthy Chinese adult residents of Hong Kong. We characterized the microbiome and resistome in stools collected from the subjects before and after travelling to diverse international locations using shotgun metagenomic sequencing and examined their associations with travel-related variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our results showed that travel neither significantly changed the taxonomic composition of the faecal microbiota nor altered the alpha (Shannon) or beta diversity of the faecal microbiome or resistome. However, travel significantly increased the number of ARGs. Ten ARGs, including aadA, TEM, mgrB, mphA, qnrS9 and tetR, were significantly enriched in relative abundance after travel, eight of which were detected in metagenomic bins belonging to Escherichia\/Shigella flexneri in the post-trip samples. In sum, 30 ARGs significantly increased in prevalence after travel, with the largest changes observed in tetD and a few qnrS variants (qnrS9, qnrS and qnrS8). We found that travel to low- or middle-income countries, or Africa or Southeast Asia, increased the number of ARG subtypes, whereas travel to low- or middle-income countries and the use of alcohol-based hand sanitizer (ABHS) or doxycycline as antimalarial prophylaxis during travel resulted in increased changes in the beta diversity of the faecal resistome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study highlights travel to low- or middle-income countries, Africa or Southeast Asia, a long travel duration, or the use of ABHS or doxycycline as antimalarial prophylaxis as important risk factors for the acquisition\/enrichment of ARGs during international travel.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jtm\/taad027","type":"journal-article","created":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T09:35:42Z","timestamp":1677576942000},"source":"Crossref","is-referenced-by-count":14,"title":["Alterations in faecal microbiome and resistome in Chinese international travellers: a metagenomic analysis"],"prefix":"10.1093","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2764-2113","authenticated-orcid":false,"given":"Man Kit","family":"Cheung","sequence":"first","affiliation":[{"name":"Department of Microbiology , Faculty of Medicine, , Hong Kong Special Administrative Region , China"},{"name":"The Chinese University of Hong Kong , Faculty of Medicine, , Hong Kong Special Administrative Region , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita W Y","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Microbiology , Faculty of Medicine, , Hong Kong Special Administrative Region , China"},{"name":"The Chinese University of Hong Kong , Faculty of Medicine, , Hong Kong Special Administrative Region , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher K C","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Microbiology , Faculty of Medicine, , Hong Kong Special Administrative Region , China"},{"name":"The Chinese University of Hong Kong , Faculty of Medicine, , Hong Kong Special Administrative Region , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chendi","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Microbiology , Faculty of Medicine, , Hong Kong Special Administrative Region , China"},{"name":"The Chinese University of Hong Kong , Faculty of Medicine, , Hong Kong Special Administrative Region , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva T K","family":"Au","sequence":"additional","affiliation":[{"name":"University Health Service, The Hong Kong Polytechnic University , Hong Kong Special Administrative Region , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer W K","family":"Yau","sequence":"additional","affiliation":[{"name":"Department of Microbiology , Faculty of Medicine, , Hong Kong Special Administrative Region , China"},{"name":"The Chinese University of Hong Kong , Faculty of Medicine, , Hong Kong Special Administrative Region , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Microbiology , Faculty of Medicine, , Hong Kong Special Administrative Region , China"},{"name":"The Chinese University of Hong Kong , Faculty of Medicine, , Hong Kong Special Administrative Region , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho Cheong","family":"Wong","sequence":"additional","affiliation":[{"name":"University Health Service, The Hong Kong Polytechnic University , Hong Kong Special Administrative Region , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonnie C K","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Medicine & Therapeutics , Faculty of Medicine, , Hong Kong Special Administrative Region , China"},{"name":"The Chinese University of Hong Kong , Faculty of Medicine, , Hong Kong Special Administrative Region , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kin On","family":"Kwok","sequence":"additional","affiliation":[{"name":"The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong , Hong Kong Special Administrative Region , China"},{"name":"Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong , Hong Kong Special Administrative Region , China"},{"name":"Hong Kong Institute of Asia-Pacific Studies, The Chinese University of Hong Kong , Hong Kong Special Administrative Region , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zigui","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Microbiology , Faculty of Medicine, , Hong Kong Special Administrative Region , China"},{"name":"The Chinese University of Hong Kong , Faculty of Medicine, , Hong Kong Special Administrative Region , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul K S","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Microbiology , Faculty of Medicine, , Hong Kong Special Administrative Region , China"},{"name":"The Chinese University of Hong Kong , Faculty of Medicine, , Hong Kong Special Administrative Region , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace C Y","family":"Lui","sequence":"additional","affiliation":[{"name":"Department of Medicine & Therapeutics , Faculty of Medicine, , Hong Kong Special Administrative Region , China"},{"name":"The Chinese University of Hong Kong , Faculty of Medicine, , Hong Kong Special Administrative Region , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Ip","sequence":"additional","affiliation":[{"name":"Department of Microbiology , Faculty of Medicine, , Hong Kong Special Administrative Region , China"},{"name":"The Chinese University of Hong Kong , Faculty of Medicine, , Hong Kong Special Administrative Region , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,3,2]]},"reference":[{"key":"2023110710113631200_ref1","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1126\/science.1176950","article-title":"Functional characterization of the antibiotic resistance reservoir in the human microflora","volume":"325","author":"Sommer","year":"2009","journal-title":"Science"},{"key":"2023110710113631200_ref2","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/S1473-3099(16)30319-X","article-title":"Import and spread of extended-spectrum \u03b2-lactamase-producing Enterobacteriaceae by international travellers (COMBAT study): a prospective, multicentre cohort study","volume":"17","author":"Arcilla","year":"2017","journal-title":"Lancet Infect Dis"},{"key":"2023110710113631200_ref3","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1093\/cid\/ciu957","article-title":"Antimicrobials increase travelers' risk of colonization by extended-spectrum betalactamase-producing Enterobacteriaceae","volume":"60","author":"Kantele","year":"2015","journal-title":"Clin Infect Dis"},{"key":"2023110710113631200_ref4","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1056\/NEJMc1912464","article-title":"Acquisition of antibiotic-resistant bacteria by U.S. international travelers","volume":"382","author":"Mellon","year":"2020","journal-title":"N Engl J Med"},{"key":"2023110710113631200_ref5","doi-asserted-by":"crossref","first-page":"12902","DOI":"10.1073\/pnas.1717163115","article-title":"Microbiome as a tool and a target in the effort to address antimicrobial resistance","volume":"115","author":"Relman","year":"2018","journal-title":"Proc Natl Acad Sci USA"},{"key":"2023110710113631200_ref6","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1186\/s13073-021-00893-z","article-title":"Destination shapes antibiotic resistance gene acquisitions, abundance increases, and diversity changes in Dutch travelers","volume":"13","author":"D'Souza","year":"2021","journal-title":"Genome Med"},{"key":"2023110710113631200_ref7","doi-asserted-by":"crossref","first-page":"6551","DOI":"10.1128\/AAC.00933-15","article-title":"The human gut microbiome as a transporter of antibiotic resistance genes between continents","volume":"59","author":"Bengtsson-Palme","year":"2015","journal-title":"Antimicrob Agents Ch"},{"key":"2023110710113631200_ref8","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.3201\/eid2507.181492","article-title":"Microbiome and antimicrobial resistance gene dynamics in international travelers","volume":"25","author":"Langelier","year":"2019","journal-title":"Emerg Infect Dis"},{"key":"2023110710113631200_ref9","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1080\/19490976.2018.1564431","article-title":"The intestinal microbiota predisposes to traveler\u2019s diarrhea and to the carriage of multidrug-resistant Enterobacteriaceae after traveling to tropical regions","volume":"10","author":"Leo","year":"2019","journal-title":"Gut Microbes"},{"key":"2023110710113631200_ref10","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.tmaid.2018.10.012","article-title":"Gut microbiota dynamics in travelers returning from India colonized with extended-spectrum cephalosporin-resistant Enterobacteriaceae: a longitudinal study","volume":"27","author":"Pires","year":"2019","journal-title":"Travel Med Infect Dis"},{"key":"2023110710113631200_ref11","doi-asserted-by":"crossref","first-page":"102199","DOI":"10.1016\/j.tmaid.2021.102199","article-title":"Changes to human faecal microbiota after international travel","volume":"44","author":"Kampmann","year":"2021","journal-title":"Travel Med Infect Dis"},{"key":"2023110710113631200_ref12","doi-asserted-by":"crossref","first-page":"taab067","DOI":"10.1093\/jtm\/taab067","article-title":"Gut microbiome and resistome changes during the first wave of the COVID-19 pandemic in comparison with pre-pandemic travel-related changes","volume":"28","author":"Peng","year":"2021","journal-title":"J Travel Med"},{"key":"2023110710113631200_ref13","doi-asserted-by":"crossref","first-page":"2057","DOI":"10.1007\/s10096-011-1540-3","article-title":"Comparative epidemiology of CTX-M-14 and CTX-M-15 producing Escherichia coli: association with distinct demographic groups in the community in New Zealand","volume":"31","author":"Freeman","year":"2012","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"2023110710113631200_ref14","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1038\/s41591-018-0160-1","article-title":"Depicting the composition of gut microbiota in a population with varied ethnic origins but shared geography","volume":"24","author":"Deschasaux","year":"2018","journal-title":"Nat Med"},{"key":"2023110710113631200_ref15","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1016\/j.ijantimicag.2017.01.030","article-title":"Epidemiology and trends in the antibiotic susceptibilities of Gram-negative bacilli isolated from patients with intra-abdominal infections in the Asia-Pacific region, 2010-2013","volume":"49","author":"Chang","year":"2017","journal-title":"Int J Antimicrob Ag"},{"key":"2023110710113631200_ref16","doi-asserted-by":"crossref","first-page":"2114","DOI":"10.1093\/bioinformatics\/btu170","article-title":"Trimmomatic: a flexible trimmer for illumina sequence data","volume":"30","author":"Bolger","year":"2014","journal-title":"Bioinformatics"},{"key":"2023110710113631200_ref17","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1038\/nmeth.1923","article-title":"Fast gapped-read alignment with Bowtie 2","volume":"9","author":"Langmead","year":"2012","journal-title":"Nat Methods"},{"key":"2023110710113631200_ref18","doi-asserted-by":"crossref","first-page":"e65088","DOI":"10.7554\/eLife.65088","article-title":"Integrating taxonomic, functional, and strain-level profiling of diverse microbial communities with bioBakery 3","volume":"10","author":"Beghini","year":"2021","journal-title":"Elife"},{"key":"2023110710113631200_ref19","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s40168-018-0401-z","article-title":"DeepARG: a deep learning approach for predicting antibiotic resistance genes from metagenomic data","volume":"6","author":"Arango-Argoty","year":"2018","journal-title":"Microbiome"},{"key":"2023110710113631200_ref20","doi-asserted-by":"crossref","first-page":"e1004557","DOI":"10.1371\/journal.pcbi.1004557","article-title":"High-specificity targeted functional profiling in microbial communities with ShortBRED","volume":"11","author":"Kaminski","year":"2015","journal-title":"PLoS Comput Biol"},{"key":"2023110710113631200_ref21","doi-asserted-by":"crossref","first-page":"3348","DOI":"10.1128\/AAC.00419-13","article-title":"The comprehensive antibiotic resistance database","volume":"57","author":"McArthur","year":"2013","journal-title":"Antimicrob Agents Chemother"},{"key":"2023110710113631200_ref22","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1093\/bioinformatics\/btu739","article-title":"UniRef clusters: a comprehensive and scalable alternative for improving sequence similarity searches","volume":"31","author":"Suzek","year":"2015","journal-title":"Bioinformatics"},{"key":"2023110710113631200_ref23","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1038\/s41587-019-0209-9","article-title":"Reproducible, interactive, scalable and extensible microbiome data science using QIIME 2","volume":"37","author":"Bolyen","year":"2019","journal-title":"Nat Biotechnol"},{"key":"2023110710113631200_ref24","doi-asserted-by":"crossref","first-page":"e00219","DOI":"10.1128\/mSystems.00219-18","article-title":"Q2-longitudinal: longitudinal and paired-sample analyses of microbiome data","volume":"3","author":"Bokulich","year":"2018","journal-title":"mSystems"},{"key":"2023110710113631200_ref25","doi-asserted-by":"crossref","first-page":"e7359","DOI":"10.7717\/peerj.7359","article-title":"MetaBAT 2: an adaptive binning algorithm for robust and efficient genome reconstruction from metagenome assemblies","volume":"7","author":"Kang","year":"2019","journal-title":"PeerJ"},{"key":"2023110710113631200_ref26","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1093\/bioinformatics\/btv638","article-title":"MaxBin 2.0: an automated binning algorithm to recover genomes from multiple metagenomic datasets","volume":"32","author":"Wu","year":"2016","journal-title":"Bioinformatics"},{"key":"2023110710113631200_ref27","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1038\/nmeth.3103","article-title":"Binning metagenomic contigs by coverage and composition","volume":"11","author":"Alneberg","year":"2014","journal-title":"Nat Methods"},{"key":"2023110710113631200_ref28","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1038\/s41564-018-0171-1","article-title":"Recovery of genomes from metagenomes via a dereplication, aggregation and scoring strategy","volume":"3","author":"Sieber","year":"2018","journal-title":"Nat Microbiol"},{"key":"2023110710113631200_ref29","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1038\/s41564-017-0012-7","article-title":"Recovery of nearly 8,000 metagenome-assembled genomes substantially expands the tree of life","volume":"2","author":"Parks","year":"2017","journal-title":"Nat Microbiol"},{"key":"2023110710113631200_ref30","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1101\/gr.186072.114","article-title":"CheckM: assessing the quality of microbial genomes recovered from isolates, single cells, and metagenomes","volume":"25","author":"Parks","year":"2015","journal-title":"Genome Res"},{"key":"2023110710113631200_ref31","doi-asserted-by":"crossref","first-page":"1925","DOI":"10.1093\/bioinformatics\/btz848","article-title":"GTDB-Tk: a toolkit to classify genomes with the genome taxonomy database","volume":"36","author":"Chaumeil","year":"2020","journal-title":"Bioinformatics"},{"key":"2023110710113631200_ref32","doi-asserted-by":"crossref","first-page":"R60","DOI":"10.1186\/gb-2011-12-6-r60","article-title":"Metagenomic biomarker discovery and explanation","volume":"12","author":"Segata","year":"2011","journal-title":"Genome Biol"},{"key":"2023110710113631200_ref33","author":"Wissel"},{"key":"2023110710113631200_ref34","doi-asserted-by":"crossref","first-page":"e001315","DOI":"10.1136\/bmjgh-2018-001315","article-title":"Tracking global trends in the effectiveness of antibiotic therapy using the drug resistance index","volume":"4","author":"Klein","year":"2019","journal-title":"BMJ Glob Health"},{"key":"2023110710113631200_ref35","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1101\/gr.155465.113","article-title":"Country-specific antibiotic use practices impact the human gut resistome","volume":"23","author":"Forslund","year":"2013","journal-title":"Genome Res"},{"key":"2023110710113631200_ref36","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.1099\/jmm.0.47442-0","article-title":"Low concentrations of commercial alcohol hand rubs facilitate growth of and secretion of extracellular proteins by multidrug-resistant strains of Acinetobacter baumannii","volume":"56","author":"Edwards","year":"2007","journal-title":"J Med Microbiol"},{"key":"2023110710113631200_ref37","volume-title":"CDC Yellow Book 2020: Health Information for International Travel","author":"Tan","year":"2017"},{"key":"2023110710113631200_ref38","article-title":"Microbiota-mediated colonization resistance: mechanisms and regulation","author":"Caballero-Flores","year":"2022","journal-title":"Nat Rev Microbiol"},{"key":"2023110710113631200_ref39","doi-asserted-by":"crossref","first-page":"taab022","DOI":"10.1093\/jtm\/taab022","article-title":"Role of gut microbiota in travel-related acquisition of extended spectrum beta-lactamase-producing Enterobacteriaceae","volume":"28","author":"Peng","year":"2021","journal-title":"J Travel Med"},{"key":"2023110710113631200_ref40","doi-asserted-by":"crossref","first-page":"taab053","DOI":"10.1093\/jtm\/taab053","article-title":"The traveller and antimicrobial resistance: what\u2019s new and where are we headed?","volume":"28","author":"Riddle","year":"2021","journal-title":"J Travel Med"}],"container-title":["Journal of Travel Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jtm\/advance-article-pdf\/doi\/10.1093\/jtm\/taad027\/49551386\/taad027.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jtm\/article-pdf\/30\/6\/taad027\/52712436\/taad027.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jtm\/article-pdf\/30\/6\/taad027\/52712436\/taad027.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T05:12:14Z","timestamp":1699333934000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jtm\/article\/doi\/10.1093\/jtm\/taad027\/7067541"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,2]]},"references-count":40,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,3,2]]},"published-print":{"date-parts":[[2023,10,31]]}},"URL":"https:\/\/doi.org\/10.1093\/jtm\/taad027","relation":{},"ISSN":["1195-1982","1708-8305"],"issn-type":[{"value":"1195-1982","type":"print"},{"value":"1708-8305","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,8]]},"published":{"date-parts":[[2023,3,2]]},"article-number":"taad027"}}