BACKGROUND: Increasing international travel has facilitated the transmission of various multidrug-resistant bacteria-including methicillin-resistant Staphylococcus aureus (MRSA)-across continents. Individuals may acquire MRSA from the community, healthcare facilities, or even from animal exposure. Skin contact with colonized individuals, fomites, or animals during an overseas trip may result in either asymptomatic colonization or subsequent clinically significant MRSA disease. MRSA strains that harbor the Panton-Valentine leucocidin toxin are particularly associated with community transmission and may potentially have enhanced virulence resulting in serious skin and soft tissue infections or even necrotizing pneumonia. More importantly, secondary transmission events upon return from traveling have been documented, leading to potentially detrimental outbreaks within the community or the healthcare setting. We sought to review the existing literature relating to the role of various aspects of travel in the spread of MRSA. Risk factors for acquiring MRSA during travel together with the need for targeted screening of high-risk individuals will also be explored. METHODS: Data for this article were identified via PubMed searches using a combination of search terms: "methicillin resistance," "MRSA," "livestock-associated MRSA," "community-associated MRSA," "travel," and "outbreak." The relevant articles were extensively perused to determine secondary sources of data. RESULTS AND CONCLUSIONS: Our review of the current literature suggests that international travel plays a significant role in the transmission of MRSA, potentially contributing to the replacement of existing endemic MRSA with fitter and more transmissible strains. Therefore, selective and targeted screening of travelers with risk factors for MRSA colonization may be beneficial. Healthcare professionals and patients should be considered for screening if they were to return from endemic areas, with the former group decolonized before returning to patient care work, in order to reduce the transmission of MRSA to vulnerable patient populations.
BACKGROUND: Increasing international travel has facilitated the transmission of various multidrug-resistant bacteria-including methicillin-resistant Staphylococcus aureus (MRSA)-across continents. Individuals may acquire MRSA from the community, healthcare facilities, or even from animal exposure. Skin contact with colonized individuals, fomites, or animals during an overseas trip may result in either asymptomatic colonization or subsequent clinically significant MRSA disease. MRSA strains that harbor the Panton-Valentine leucocidin toxin are particularly associated with community transmission and may potentially have enhanced virulence resulting in serious skin and soft tissue infections or even necrotizing pneumonia. More importantly, secondary transmission events upon return from traveling have been documented, leading to potentially detrimental outbreaks within the community or the healthcare setting. We sought to review the existing literature relating to the role of various aspects of travel in the spread of MRSA. Risk factors for acquiring MRSA during travel together with the need for targeted screening of high-risk individuals will also be explored. METHODS: Data for this article were identified via PubMed searches using a combination of search terms: "methicillin resistance," "MRSA," "livestock-associated MRSA," "community-associated MRSA," "travel," and "outbreak." The relevant articles were extensively perused to determine secondary sources of data. RESULTS AND CONCLUSIONS: Our review of the current literature suggests that international travel plays a significant role in the transmission of MRSA, potentially contributing to the replacement of existing endemic MRSA with fitter and more transmissible strains. Therefore, selective and targeted screening of travelers with risk factors for MRSA colonization may be beneficial. Healthcare professionals and patients should be considered for screening if they were to return from endemic areas, with the former group decolonized before returning to patient care work, in order to reduce the transmission of MRSA to vulnerable patient populations.
Authors: N Piper Jenks; M Pardos de la Gandara; B M D'Orazio; J Correa da Rosa; R G Kost; C Khalida; K S Vasquez; C Coffran; M Pastagia; T H Evering; C Parola; T Urban; S Salvato; F Barsanti; B S Coller; J N Tobin Journal: Travel Med Infect Dis Date: 2016-10-20 Impact factor: 6.211
Authors: Francesco Di Ruscio; Jørgen Vildershøj Bjørnholt; Truls Michael Leegaard; Aina E Fossum Moen; Birgitte Freiesleben de Blasio Journal: PLoS One Date: 2017-06-22 Impact factor: 3.240
Authors: Natasha E Holmes; J Owen Robinson; Sebastiaan J van Hal; Wendy J Munckhof; Eugene Athan; Tony M Korman; Allen C Cheng; John D Turnidge; Paul D R Johnson; Benjamin P Howden Journal: BMC Infect Dis Date: 2018-03-05 Impact factor: 3.090
Authors: Francesco Di Ruscio; Giorgio Guzzetta; Jørgen Vildershøj Bjørnholt; Truls Michael Leegaard; Aina Elisabeth Fossum Moen; Stefano Merler; Birgitte Freiesleben de Blasio Journal: Proc Natl Acad Sci U S A Date: 2019-07-01 Impact factor: 11.205
Authors: Melissa J Ward; Mariya Goncheva; Emily Richardson; Paul R McAdam; Emma Raftis; Angela Kearns; Robert S Daum; Michael Z David; Tsai Ling Lauderdale; Giles F Edwards; Graeme R Nimmo; Geoffrey W Coombs; Xander Huijsdens; Mark E J Woolhouse; J Ross Fitzgerald Journal: Genome Biol Date: 2016-07-26 Impact factor: 13.583