摘要：Objectives. The objective of this study was to determine the role international travel plays in US Campylobacter epidemiology and antimicrobial resistance. Methods. In this study, epidemiological and antimicrobial resistance data, encompassing the years 2005 to 2011, from 10 sites participating in the Foodborne Diseases Active Surveillance Network were linked. The 10 sites are represented by 7 states that conducted surveillance on a statewide level, and 3 states which conducted county-level surveillance. Cases of Campylobacter among persons with history of international travel in the week prior to illness were compared with cases among individuals with no international travel. Results. Approximately 18% of Campylobacter infections were estimated to be associated with international travel, and 60% of international travel-associated infections had a quinolone-resistant Campylobacter isolate. Conclusions. We confirm that international travel plays a significant role in campylobacteriosis diagnosed in the United States. Recognizing this is important to both medical management decisions and understanding burden and attribution estimates of US campylobacteriosis and antibiotic-resistant campylobacteriosis. In the United States, Campylobacter is estimated to affect more than 1.3 million people annually, with more than 14.3 laboratory-confirmed cases per 100 000 people. 1,2 Many of these infections are attributed to high levels (reported at 47% in the United States in 2011) of bacterial contamination in US poultry 3 and to other domestic US exposures. However, there are an estimated 400 to 500 million cases of campylobacteriosis occurring annually worldwide, 4 and recent findings suggest a large proportion of US Campylobacter infections might actually be acquired internationally and diagnosed upon return to the United States. 5 Of particular concern is that there appears to be a high prevalence of antibiotic resistance in Campylobacter outside of the United States, primarily in developing countries. 6,7 Understanding the epidemiology of travel-associated Campylobacter infections is important for increasing awareness of this infection in international travelers and among providers that care for these patients. It is also important for assessing the burden of domestically acquired Campylobacter illnesses in the United States and attributing infections to certain food commodities. Lastly, it should be considered in determining effectiveness of US interventions, including efforts of the US Department of Agriculture (USDA) and the US Food and Drug Administration (FDA), to address foodborne bacterial infections in general and antimicrobial resistance in particular. We used data collected by the Foodborne Diseases Active Surveillance Network (FoodNet) from 2005 to 2011 to describe Campylobacter -infected persons, including their demographics, travel history, and outcomes such as hospitalization and death. In addition, we linked antimicrobial susceptibility testing results from select isolates as part of the National Antimicrobial Resistance Monitoring System (NARMS) to epidemiological surveillance data to help determine the contribution of international travel to antimicrobial resistance detected in the United States.
