A preliminary analysis of hand disinfection use by travellers and their colonisation-risk with multi-resistant bacteria: a proof-of-concept study.

Abstract

Background: International travellers have the potential to transmit multidrug-resistant bacteria. However, the role of hygiene measures during travel has yet to be investigated.

Method: Travellers were asked about their use of disinfectants and hygiene behaviour. Stool samples were analysed for Gram-negative multi-resistant bacteria (MDRO). These data were analysed, and a new MDRO risk map was developed and compared with data from existing literature.

Result: Of 214 travellers, 6 (2.8%) tested positive for an MDRO before and 16 (7.5%) after the trip, with travel in known high-risk MDRO areas. Most travellers, 174 (81.3%), regularly used disinfectants; only 36 (16.8%) did not. There was no statistically significant correlation between the use of a disinfectant and colonization with MDRO. In our and comparable studies, a high-risk region on the risk map was associated with an increased number of MDRO or extended-spectrum beta-lactamase (ESBL) positive returns.

Conclusion: Travellers showed a high willingness to use disinfectants. This preliminary study highlights the need for larger, randomized studies to better assess the true impact of hand disinfectants on MDRO acquisition.