Antibiotic resistance (AR) is currently a major threat to global health, calling for a One Health approach to be properly understood, monitored, tackled, and managed. Potential risk factors for AR are often studied in specific high-risk populations, but are still poorly understood in the general population. Our aim was to explore, describe, and characterize potential risk factors for carriage of Extended-Spectrum Beta-Lactamase-resistant E. coli (ESBL-EC) in a large sample of European individuals aged between 16 and 67 years recruited from the general population in Southern Germany, the Netherlands, and Romania. Questionnaire and stool sample collection for this cross-sectional study took place from September 2018 to March 2020. Selective culture of participants’ stool samples was performed for detection of ESBL-EC. A total of 1,183 participants were included in the analyses: 333 from Germany, 689 from the Netherlands, and 161 from Romania. Travels to Northern Africa (aOR 4.03, 95% CI 1.67-9.68), Sub-Saharan Africa (aOR 4.60, 95% CI 1.60-13.26), and Asia (aOR 4.08, 95% CI 1.97-8.43) were identified as independent risk factors for carriage of ESBL-EC carriage. Therefore, travel to these regions should continue to be routinely inquired risk factors in clinical practice when considering antibiotic therapy.

中文翻译：

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国际旅行是在大量欧洲个体中携带产超广谱 β-内酰胺酶的大肠杆菌的风险因素 - AWARE 研究

抗生素耐药性 (AR) 目前是对全球健康的主要威胁，需要对 One Health 方法进行正确理解、监测、处理和管理。AR 的潜在危险因素通常在特定的高危人群中进行研究，但在普通人群中仍然知之甚少。我们的目的是探索、描述和描述携带超广谱 β-内酰胺酶耐药大肠杆菌的潜在风险因素(ESBL-EC) 在从德国南部、荷兰和罗马尼亚的普通人群中招募的 16 至 67 岁的欧洲人的大样本中。这项横断面研究的问卷调查和粪便样本收集于 2018 年 9 月至 2020 年 3 月进行。对参与者的粪便样本进行选择性培养以检测 ESBL-EC。共有 1,183 名参与者被纳入分析：333 名来自德国，689 名来自荷兰，161 名来自罗马尼亚。前往北非 (aOR 4.03, 95% CI 1.67-9.68)、撒哈拉以南非洲 (aOR 4.60, 95% CI 1.60-13.26) 和亚洲 (aOR 4.08, 95% CI 1.97-8.43) 被确定为独立风险ESBL-EC运输的运输因素。所以，