SuperbugsA quarter of migrants to Europe infected with drug-resistant bacteria

Published 21 May 2018

A new review of research on migrant populations in Europe has found that more than a quarter are infected or colonized with antibiotic-resistant bacteria, with evidence suggesting that the pathogens are being acquired along the migration route or in host countries. The findings come amid a recent wave of immigration that has brought more than two million migrants to Europe since 2015, an influx that’s been driven in part by conflicts and instability in the Middle East and Africa.

A new review of research on migrant populations in Europe has found that more than a quarter are infected or colonized with antibiotic-resistant bacteria, with evidence suggesting that the pathogens are being acquired along the migration route or in host countries.

The findings are from a review and meta-analysis of observational studies on antimicrobial resistance (AMR) in migrants conducted by researchers from Imperial College London and published yesterday in the The Lancet Infectious Diseases. The researchers also found that the prevalence of AMR carriage or infection was even higher among refugees and asylum seekers and in high-migrant community settings. But they did not find high rates of AMR transmission from migrants to host populations.

CIDRAP notes that the findings come amid a recent wave of immigration that has brought more than two million migrants to Europe since 2015, an influx that’s been driven in part by conflicts and instability in the Middle East and Africa. The authors of the study suggest that the poor conditions that many migrants are exposed to in transit and in host countries—including crowded refugee camps and detention centers with poor sanitation and little access to healthcare—may promote the spread of antibiotic-resistant bacteria. The role of these settings in the spread of infectious diseases has been highlighted in previous studies.

Poor social conditions in these settings, such as inadequate sanitation, overcrowding, and restricted access to health services (including antibiotics or vaccinations), favor the spread of antibiotic-resistant infections,” the authors write.

Prevalence of infection and colonization
In their review of papers published from January 2000 through January 2017, the researchers identified 23 studies reporting on antibiotic resistance in 2,319 migrants. Countries of origin included Syria, Afghanistan, Eritrea and other countries in the Middle East, Africa, and Asia. Of these migrants, 77 percent were refugees or asylum seekers.

Nineteen of the studies reported on methicillin-resistant Staphylococcus aureus (MRSA), and 12 of the studies reported on AMR in gram-negative bacteria. When they were reported, the clinical manifestations were mainly skin and other soft-tissue infections and diarrhea.

Overall, the pooled prevalence of any detected AMR infection or carriage among migrants was 25.4 percent, with MRSA accounting for 7.8 percent and drug-resistant gram-negative bacteria accounting for 27.2 percent. The pooled prevalence of infection was 3 percent, and the pooled prevalence of carriage was 23 percent.