The molecular epidemiology of ESBL genes in returning travellers
Research type
Research Study
Full title
The molecular epidemiology of CTX-M antibiotic resistance genes in the faecal microbiome of humans acquiring ESBL-producing Enterobacteriaceae
IRAS ID
167111
Contact name
Edward R Bevan
Contact email
Duration of Study in the UK
2 years, 11 months, 30 days
Research summary
Do visitors travelling to the Indian subcontinent acquire antibiotic resistant bacteria and carry those on return to the UK, or do antibiotic-resistance genes transfer to the pre-existing host E.coli?
The bacterium Escherichia coli (E.coli) normally inhabits the bowel in healthy individuals, but is also the commonest cause of septicaemia in adults. Unfortunately, E.coli is often resistant to the most effective antibiotics available, and this is a particular problem in countries on the Indian-subcontinent.
The spread of resistant E.coli through international travel presents a significant challenge, as these bacteria may spread within hospitals. Travellers from western countries who visit developing countries often become asymptomatic carriers of antibiotic resistant bacteria. The mechanism of acquisition of resistant bacteria in these cases is not fully understood.
Antibiotic resistance genes are often carried on circular rings of bacterial DNA called plasmids which can move between different bacterial species. Resistant E.coli are acquired from contaminated food or drinking water.
Using a group of healthy volunteers based at the University of Birmingham, who plan to travel to the Indian subcontinent, this study will determine the mechanism by which antibiotic resistant genes are acquired. This is important because it will support the development of techniques to prevent the acquisition of antibiotic-resistant bacteria, and the removal of resistant bacteria using new technologies.
Volunteers will be asked to provide stool samples on eight occasions including before and after travel. They will also be asked to complete a short questionnaire. Laboratory work will be undertaken at University of Birmingham and Public Health England (PHE) Laboratory at Birmingham Heartlands Hospital. Bacterial DNA will be sequenced which will allow the mechanism of antibiotic resistance gene transfer to be determined. This work will run over 3 years and is funded through PHE and the Medical Innovation Development Research Unit (MIDRU) trust fund.
REC name
West Midlands - South Birmingham Research Ethics Committee
REC reference
15/WM/0037
Date of REC Opinion
4 Mar 2015
REC opinion
Further Information Favourable Opinion