Use of antimicrobials in industrial food animal production is associated with the presence of multidrug-resistant Staphylococcus aureus among animals and humans. The livestock-associated (LA) methicillin-resistant S. aureus (MRSA) clonal complex 9 (CC9) is associated with animals and related workers in Asia. This study aimed to explore the genotypic and phenotypic markers of LA-MRSA CC9 in humans. We conducted a cross-sectional study of livestock workers and controls in Guangdong, China. The study participants responded to a questionnaire and provided a nasal swab for S. aureus analysis. The resulting isolates were assessed for antibiotic susceptibility, multilocus sequence type, and immune evasion cluster (IEC) genes.
Methicillin-resistant Staphylococcus aureus (MRSA) is one of the leading causes of antibiotic-resistant nosocomial infections, causing diseases ranging from minor skin infections to severe septicemia and pneumonia, and is of particular concern because few antibiotics are effective at treating infections caused by the pathogen. The epidemiology of MRSA has changed with the increasing emergence of community-associated MRSA (1, 2). Recently, another MRSA clone emerged in the community, which was observed in livestock and related workers and was referred to as livestock-associated MRSA (LA-MRSA) (3). Livestock, especially pigs, can serve as reservoirs for LA-MRSA, and the bacteria can also be transmitted to humans in close contact with MRSAcolonized animals (4, 5).LA-MRSA isolates have unique molecular characteristics that distinguish them from community-associated MRSA and health care-associated MRSA, and these characteristics vary according to the geographic area. Sequence type 398 (ST398) has been referred to as the most pandemic LA-MRSA in Europe and North America, while ST9 is the most prevalent LA-MRSA in most Asian countries (3). However, persons living in areas of high livestock density were also found to have a greater risk of LA-MRSA carriage even if they lacked direct contact with livestock (6, 7). Thus, the possibility of direct and indirect livestock contact as a potential source of human MRSA infection has become a growing public health concern.Few reports have described the epidemiology and molecular characteristics of LA-MRSA in developing countries in Asia. In China, MRSA has been isolated from pigs and pig workers (8, 9). However, there is still very limited information on LA-MRSA infection among healthy people. In addition, few studies examining human MRSA carriage have attempted to differentiate humanfrom livestock-associated isolates based on genotypic and phenotypic markers. The goals of this study, therefore, were to determine the prevalence of MRSA (including LA-MRSA) in livestock workers and control workers in Guangdong, as well as to use the multifactor dimensionality reduction method to detect the genotypic and phenotypic markers for LA-MRSA.
MATERIALS AND METHODSEthics statement. This study was approved by the Ethics Committee of Guangdong Pharmaceutical Universit...