Livestock-associated methicillin-resistant Staphylococcus aureus (clonal complex 398) causing bacteremia and epidural abscess

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) clonal complex (CC) 398 has spread from pigs to humans, but rarely from person to person. This strain of MRSA has been considered less virulent than others. Livestock-associated MRSA CC398 (LA-MRSA CC398) is particularly known to colonize pig farmers. Recent studies have shown an increasing number of people colonized with LA-MRSA CC398 and invasive infections caused by LA-MRSA CC398. The case of a previously healthy, 61-year-old woman admitted to a Danish regional hospital is reported here. She presented with fever, severe back pain, and bilateral hyperreflexia of patellar and Achilles reflexes. Blood tests revealed leukocytosis and elevated Creactive protein. Empiric antimicrobial therapy with intravenous piperacillin-tazobactam was initiated, but blood cultures grew MRSA and antimicrobial therapy was changed to intravenous vancomycin. Whole-genome sequencing showed that the MRSA strain belonged to LA-MRSA CC398 spa type t011 and was Panton-Valentine leukocidin-negative. Magnetic resonance imaging revealed an epidural abscess at the level of L1-L4. Surgery was performed and pus from the abscess grew MRSA. The duration of antimicrobial therapy was 12 weeks. This case report describes bacteremia with LA-MRSA CC398 in a previously healthy patient without exposure to livestock or previous admission to a hospital. This highlights the risk of person-to-person transmission of LA-MRSA CC398 and brings into question whether LA-MRSA CC398 may have a greater pathogenic potential than previously assumed.

Detection of methicillin-resistant Staphylococcus aureus in broiler and broilers farm workers in Duhok, Iraq by using conventional and PCR techniques

“…The infection with LA-MRSA has been globally documented (2,3). At present, MRSA strains have been identified by using the biochemical test to detect the phenotypical characterization of MRSA which appeared resistance to all the antibiotics that have been manufactured to date (4,5). The mecA gene, a (associated with resistance in MRSA) encodes the altered penicillin binding protein (PBPa), which has a low affinity for β-lactam group antibiotics and prevent it to link with β-lactams.…”

Prevalence of methicillin resistant Staphylococcus aureus (MRSA) in pigs and workers at abattoirs in Trinidad and Tobago

“…It is noteworthy to mention that MRSA was not isolated from pig farm workers in an earlier study in the country [16]. The low prevalence of MRSA in slaughterhouse workers should not be ignored since LA-MRSA can cause the same types of infections as HA-MRSA strains [45].…”

Phenotypic Characterization and Whole Genome Analysis of a Strong Biofilm-Forming Staphylococcus aureus Strain Associated With Subclinical Bovine Mastitis in Colombia

“…In Denmark, cases of infected humans with strains from CC97 increased 11-fold between 2007 and 2011 (40). Likewise, other studies have also highlighted the rapid increase of the number of people colonized with S. aureus of the ST398 (CC398), which is a genotype shared by pigs (primary host), cattle, chicken, horses, and humans (mainly in farmer working) (41,42). The ST398 had been recognized as a livestock-associated MRSA (LA-MRSA) strain.…”

“…The ST398 had been recognized as a livestock-associated MRSA (LA-MRSA) strain. This clone generally is transmitted from pigs to humans, but rarely from person to person (42). However, a recent report from Denmark described a severe case of infection with LA-MRSA CC398, which was presented with bacteremia and an epidural abscess (42).…”

“…This clone generally is transmitted from pigs to humans, but rarely from person to person (42). However, a recent report from Denmark described a severe case of infection with LA-MRSA CC398, which was presented with bacteremia and an epidural abscess (42). Since the patient was not exposed to livestock, the authors suggested that the transmission was from person to person (42).…”