The authors analyzed data on 444 imported cases of methicillin-resistant Staphylococcus aureus (MRSA) in Sweden during the period 2000-2003. The risk for MRSA carriage or infection in returning travellers ranged from 0.1 per million travellers returning from Nordic countries to 59.4 per million travellers returning from North Africa and the Middle East. 

The authors present data on 15 individuals infected by Panton-Valentine leukocidin (PVL) -producing strains of Staphylococcus aureus. Intra-familial spread was documented in one case, and occupational transmission was most likely in another case. spa typing of the strains revealed a broad range of variants, though some strains were clonally related. Methicillin-resistant Staphylococcus aureus (MRSA) was found in three cases.

This review outlines how increasing modalities of travel, such as aeromedical evacuation of civilians and of military personnel, medical tourism and any shared healthcare across countries, are risks for the transmission of multidrug-resistant organisms via the patient, from country to country.