Tropical beach with hidden bacteria carrying backpacks, symbolizing the risk of acquiring antibiotic resistance during travel.

Travel Bug: How Tropical Trips Could Expose You to Antibiotic-Resistant Superbugs

Jordan Keane in Health & Wellness December 2025 • 4 min read.

"Unpack the hidden risks of international travel and learn how to protect yourself from antibiotic-resistant Enterobacteriaceae lurking in tropical paradises."

The allure of exotic destinations often overshadows a less glamorous reality: the risk of acquiring multi-drug resistant Enterobacteriaceae (MRE). These bacteria, increasingly prevalent in low and middle-income countries, pose a significant threat to travelers. While awareness of ESBL-E (extended spectrum beta-lactamase producing Enterobacteriaceae) acquisition is growing, the dangers of pAmpC-E (plasmid-mediated AmpC) remain largely unexplored.

MRE acquisition rates can range from 20% to a staggering 80% depending on the destination, with the Indian subcontinent posing a particularly high risk. Digestive issues, like diarrhea, and antibiotic use during travel are major contributing factors. However, most studies focus primarily on ESBL-E, leaving pAmpC-E, which exhibits a slightly different resistance profile, in the shadows.

This article sheds light on pAmpC-E, detailing its prevalence and persistence among travelers returning from tropical regions. Understand the risks, protect your health, and travel smart.

What Exactly Are pAmpC-E and Why Should You Care?

Tropical beach with hidden bacteria carrying backpacks, symbolizing the risk of acquiring antibiotic resistance during travel.

pAmpC-E are Enterobacteriaceae that produce AmpC enzymes, which confer resistance to cephalosporin antibiotics. This resistance can arise from either an over-expression of chromosomal AmpC or the acquisition of a plasmid-encoded AmpC gene. While the former is often linked to hospital-acquired infections, the latter is increasingly found in community settings. These plasmid-mediated AmpC (pAmpC) genes originate from chromosomal genes mobilized onto plasmids.

Unlike ESBL-E, pAmpC-E can be difficult to detect, especially in species already carrying a chromosomal ampC gene, potentially leading to an underestimation of their true prevalence. However, their incidence is on the rise, making it crucial to understand the risks associated with their acquisition during travel.

What are Enterobacteriaceae? A large family of bacteria, some of which are harmless while others can cause infections.
What does 'multi-drug resistant' mean? These bacteria have developed resistance to multiple antibiotics, making infections harder to treat.
What are plasmids? Small DNA molecules within bacteria that can carry genes for antibiotic resistance and be transferred between bacteria.

A study was conducted on 574 French travelers returning from tropical regions. Researchers analyzed stool samples to detect the presence of pAmpC-E. The results revealed that 8.5% of travelers acquired pAmpC-E during their trip, with acquisition rates varying significantly by region.

Staying Safe: Practical Tips to Minimize Your Risk

While the study highlights the risks associated with pAmpC-E acquisition during travel, it's important to remember that simple precautions can significantly reduce your risk. By staying informed, practicing good hygiene, and making responsible choices, you can enjoy your travels with greater peace of mind. Continued research and surveillance are crucial to understanding and combating the spread of antibiotic resistance on a global scale.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1371/journal.pone.0206909, Alternate LINK

Title: Acquisition Of Plasmid-Mediated Cephalosporinase Producing Enterobacteriaceae After A Travel To The Tropics

Subject: Multidisciplinary

Journal: PLOS ONE

Publisher: Public Library of Science (PLoS)

Authors: Florian Lorme, Naouale Maataoui, Emilie Rondinaud, Marina Esposito-Farèse, Olivier Clermont, Etienne Ruppe, Guillaume Arlet, Nathalie Genel, Sophie Matheron, Antoine Andremont, Laurence Armand-Lefevre

Published: 2018-12-18

Everything You Need To Know

What exactly are pAmpC-E, and why should I be concerned about them?

pAmpC-E are Enterobacteriaceae that produce AmpC enzymes. These enzymes confer resistance to cephalosporin antibiotics. This resistance can be due to an over-expression of chromosomal AmpC or the acquisition of a plasmid-encoded AmpC gene. They are important because they are increasingly found outside of hospitals and are becoming more common in community settings. Because pAmpC-E are harder to detect than ESBL-E, the true prevalence of pAmpC-E could be underestimated, making the rise in their incidence concerning.

What does it mean when Enterobacteriaceae are described as 'multi-drug resistant,' and why is this a problem?

Multi-drug resistance in Enterobacteriaceae means that these bacteria have developed resistance to multiple antibiotics. This is significant because infections caused by these bacteria become harder to treat, potentially leading to more severe illness and complications. The rise of multi-drug resistant bacteria, like ESBL-E and pAmpC-E, is a global health concern, as it limits treatment options and can increase the spread of resistant genes.

What are plasmids, and how do they contribute to antibiotic resistance in bacteria?

Plasmids are small DNA molecules within bacteria that can carry genes for antibiotic resistance. They are significant because they can be transferred between bacteria, even between different species, facilitating the rapid spread of resistance. In the context of pAmpC-E, plasmid-mediated AmpC genes originate from chromosomal genes mobilized onto plasmids, which then spread resistance more easily.

What are ESBL-E, and how do they relate to pAmpC-E?

ESBL-E stands for extended-spectrum beta-lactamase producing Enterobacteriaceae. ESBL-E are bacteria resistant to many common antibiotics, but unlike pAmpC-E, they are easier to detect. ESBL-E has been studied more, but pAmpC-E also poses a threat, as it is harder to detect, and therefore is not as well understood.

What practical steps can I take to lower my chances of getting pAmpC-E while traveling?

To minimize the risk of acquiring pAmpC-E during travel, one should practice good hygiene, including frequent hand washing, especially before meals. It's also important to be cautious about food and water sources, opting for bottled water and thoroughly cooked food. Responsible antibiotic use is crucial, avoiding them unless prescribed by a doctor. Continued research and surveillance are crucial to understanding and combating the spread of antibiotic resistance on a global scale.