Faecal metagenomics on acquisition of AMR in travellers

Recent prospective studies among travellers have sought to quantify the risk of importation, and duration of colonisation, associated with travel to high risk countries and antibiotic use. Most studies have reported that persistence beyond three months of travel is unusual. However these studies have been predominantly employed culture-based methods, or used predefined primers for commoner resistance-conferring alleles. These suffer from limitations of culturability of archived organisms that may be of low prevalence but under antibiotic or other pressures become clinically significant, and thus may underestimate the true burden of acquired resistance. Metagenomic approaches to faecal and other host-associated microbiomes have been developed for exploration of host-microbial interactions in health and disease. These techniques obviate some of these limitations of culture-based methods and allow a richer exploration of the faecal microbiome. Specifically this technology can explore the resistome with use of established libraries of resistance-associated sequences. Early presumptive self-treatment for travellers’ diarrhoea is recommended for selected travellers coming through The Hospital for Tropical Diseases travel clinic, based on high quality evidence of efficacy in shortening duration of illness. We studied travellers before and after travel to high-risk countries to assess the prevalence, persistent of metagenomics-derived resistance elements, and explored associations with antibiotic exposure.

Project Duration: 2016 – 2018
LSHTM lead investigator: Michael Brown
LSHTM staff: Ron Behrens
Funding: UCLH Biomedical Research Centre
Collaborators: PHE