Antibiotics could be making superbugs more common through travelers around the world.

Traveler's diarrhea is often treated with antibiotics, but this could put travelers at a greater risk of contracting diseases caused by drug-resistant bacteria, a new study concludes.

Researchers are calling on healthcare professionals to reserve the use of antibiotics to just the most severe cases of the common disorder. Most cases of traveler's diarrhea are mild, and resolve on their own without need for antibiotics, according to researchers on the study.

Stool samples were collected from 430 residents of Finland before and after they traveled outside of Scandinavia. Investigators were looking to see if the travelers contracted a certain drug-resistant bacteria. This microorganism produces extended-spectrum beta-lactamase (ESBL), an enzyme known to provide protection for bacteria from a wide range of drugs. Researchers found the 21 percent of the subjects examined tested positive for ESBL-producing bacteria, including 37 percent of those who took antibiotics for traveler's diarrhea. The Centers for Disease Control and Prevention (CDC) recently stated this class of microorganisms constitutes a significant threat to public health.

South Asia was found to be the most dangerous spot for travelers to contract ESBL-producing bacteria. Around 80 percent of all subjects who traveled to that region and took antibiotics for treatment of traveler's diarrhea tested positive for the drug-resistant bacteria. Eastern and southeastern Asia, as well as northern Africa and the Middle East were also found to be high-risk areas for travelers.

"More than 300 million people visit these high-risk regions every year. If approximately 20 percent of them are colonized with the bugs, these are really huge numbers. This is a serious thing. The only positive thing is that the colonization is usually transient, lasting for around half a year," Anu Kantele, associate professor of infectious diseases at Helsinki University Hospital in Finland, said.

Travelers could spread drug-resistant bacteria once they come back home, researchers in the study caution readers. Roughly 90 percent of subjects who contracted the bacteria experienced infections caused by the microorganisms within a year of their return.
 
The uncomfortable condition of traveler's diarrhea is the most common illness experienced by people traveling to other lands.

"Eat only food that is cooked and served hot. (Avoid, for example, food that has been sitting on a buffet.) Eat raw fruits and vegetables only if you have washed them in clean water or peeled them. Drink only beverages from factory-sealed containers, and avoid ice (because it may have been made from unclean water)," CDC officials advise American tourists.

Travelers with diarrhea should avoid antibiotics and instead drink plenty of fluids to avoid dehydration, and take non-antibacterial over-the-counter treatments, Kantele recommends.

Study of the effect of antibacterial drugs and traveler's diarrhea was published in the journal Clinical Infectious Diseases.

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