Transmission of Methicillin-Resistant Staphylococcus aureus CC398 from Livestock Veterinarians to Their Household Members

Verkade, Erwin; Bergh, Marjolein Kluytmans-van den; Benthem, Birgit van; Cleef, Brigitte van; Rijen, Miranda van; Bosch, Thijs; Schouls, Leo M.; Kluytmans, Jan

doi:10.1371/journal.pone.0100823

Cited by 36 publications

(23 citation statements)

References 36 publications

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“…Therefore, the environment appears to be a very important determinant for human carriage, and true human-to-human transmission rates are better studied in other settings. In a study where household members of pig veterinarians did not have contact with livestock, transmissibility of LA-MRSA appeared to be reduced, compared to non-LA-MRSA [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Livestock-Associated MRSA in Household Members of Pig Farmers: Transmission and Dynamics of Carriage, A Prospective Cohort Study

et al. 2015

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This prospective cohort study describes carriage of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) in household members from 49 farrowing pig farms in the Netherlands (2010–2011). Of 171 household members, 4% were persistent MRSA nasal carriers, and the MRSA prevalence on any given sampling moment was 10% (range 7-11%). Working in the stables (of which 98% was MRSA-positive, prevalence ratio (PR) = 2.11 per 10 hours), working with sows (PR=1.97), and living with an MRSA-positive pig farmer (PR=4.63) were significant determinants for MRSA carriage. Significant protective factors were carriage of methicillin-susceptible Staphylococcus aureus (MSSA) (PR=0.50), and wearing a facemask when working in the stables (37% decreased prevalence). All MRSA strains during the study period were known livestock-associated types. The bacteriophage φ3 was not found in household members. Transmission from pigs and the environment appeared to be important determinants; human-to-human transmission could not sufficiently be differentiated. Wearing a facemask when working in the stables and carriage of MSSA are potential interventional targets.

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Section: Discussionmentioning

confidence: 99%

Livestock-Associated MRSA in Household Members of Pig Farmers: Transmission and Dynamics of Carriage, A Prospective Cohort Study

et al. 2015

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“…In this study, MRSA belonging to MC398 is defined and referred to as LA-MRSA. We used LA-MRSA isolates collected during a 2-year prospective longitudinal cohort study among 135 Dutch livestock veterinarians and their household members (16,17). Samples were taken at baseline (0 months, t ϭ 0m) and at 2 to 3 (t ϭ 2m), 6 (t ϭ 6m), 10 (t ϭ 10m), and 14 (t ϭ 14m) months after inclusion.…”

Section: Methodsmentioning

confidence: 99%

“…To assess this, we used LA-MRSA isolates originating from a 2-year prospective longitudinal cohort study in which livestock veterinarians and their household members were repeatedly sampled for the presence of S. aureus (16,17).…”

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confidence: 99%

Transmission and Persistence of Livestock-Associated Methicillin-Resistant Staphylococcus aureus among Veterinarians and Their Household Members

Bosch

Verkade

Luit

et al. 2015

Appl Environ Microbiol

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Shortly after the introduction of methicillin in 1959, methicillin-resistant Staphylococcus aureus (MRSA) emerged as an important human pathogen (1). Currently, MRSA is held responsible for numerous hospital-acquired infections worldwide, such as skin infections and toxic shock syndrome (2). MRSA also emerged as a community-acquired pathogen and in recent years has increasingly been isolated from livestock (3, 4). Livestock-associated MRSA (LA-MRSA) can be separated from other MRSA strains, as all strains belong to one multilocus sequence type (MLST) clonal complex. Since the first detection of LA-MRSA in 2003, it has been found in many countries worldwide (5-7). In the Netherlands, LA-MRSA has become quite prominent, making up approximately 40% of all MRSA strains isolated from humans that were sent to the National Institute for Public Health and the Environment (RIVM) for molecular typing as part of the Dutch national MRSA surveillance.From 2002 to 2007, all Dutch MRSA isolates were typed with pulsed-field gel electrophoresis (PFGE) using SmaI, but because of its labor-intensive character and the subjectivity involved in interpretation, this method was replaced by spa typing in 2007 (8, 9). In addition, multilocus variable-number tandem-repeat analysis (MLVA) was introduced for S. aureus in 2008 (10-12), and since then all isolates have been characterized by MLVA and spa typing.Although spa and MLVA typing are very well suited for characterizing most MRSA isolates, they provide very low discriminatory power for isolates belonging to MLVA complex 398 (MC398) (10, 13). The limited differentiation of MC398 isolates, representing LA-MRSA, has impeded investigations on transmission events and possible outbreaks caused by LA-MRSA.Transmission of LA-MRSA has been described in multiple reports, suggesting that human-to-human transmission of LA-MRSA is less likely to occur than that of other MRSA lineages (14,15). However, these reports describe the transmission of the MC398 (or CC398) clade based on epidemiology and limited molecular characterization of isolates, making it difficult to interpret if actual transmission events with LA-MRSA did occur.Recently, a new high-resolution typing technique for LA-MRSA was introduced named whole-genome mapping (13). Using this method, epidemiologically unrelated LA-MRSA isolates that were previously indistinguishable by spa and MLVA typing can now be differentiated. Furthermore, the method is able to identify transmission events between livestock veterinarians and their household, showing its potential as a typing tool for LA-MRSA.In the study presented here, we further investigated the potential of whole-genome mapping to identify possible transmission of

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“…Family members that are not in direct contact with pigs are also colonized by MRSA CC398 although to a lesser extent [51]. Humanto-human transmission of MRSA CC398 seems to occur rarely compared with other MRSA lineages, as shown by the findings of a recent study that the prevalence of MRSA CC398 among relatives living with veterinarians was considerably inferior compared with other MRSA clones among relatives living with control patients [52]. Small hospital outbreaks of MRSA ST398 have occurred, the first in a Dutch hospital in 2007, but this phenomenon is still infrequent.…”

Section: Mrsa In Food-chain Animalsmentioning

confidence: 99%

Methicillin-resistant Staphylococcus aureus among animals: current overview

Aires-de-Sousa

2017

Clinical Microbiology and Infection

228

184

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Currently, methicillin-resistant Staphylococcus aureus (MRSA) is a universal threat. After being well established in the healthcare setting, it has emerged in the community among people with no risk factors for MRSA acquisition, therefore imposing a new threat. The subsequent detection of MRSA colonizing or infecting animals as well as in food of animal origin was of major concern, revealing new reservoirs for MRSA. The major MRSA clonal lineages circulating in the different settings, i.e. in hospitals, in the community and among animals, are described here, differentiating between clones colonizing companion and food-chain animals. Particular attention is given to the widely spread livestock-associated MRSA clonal complex (CC) 398, which is mainly associated with professional exposure but may be of high pathogenicity. The recent detection of a mecA homologue, designated mecC, with a wide geographical distribution in Europe, and including a large diversity of hosts (food-chain, companion and wildlife animals and also detected in water samples) adds to the threat. Domestication as well as globalization of the livestock industry have intensified exchanges between human and animal bacteria. We report here several cases of transmission of MRSA between companion or food-chain animals and humans, as well as some MRSA clones of human origin that have adapted to new animal hosts eventually by losing useless virulence factors or acquiring new mobile genetic elements.

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Transmission of Methicillin-Resistant Staphylococcus aureus CC398 from Livestock Veterinarians to Their Household Members

Cited by 36 publications

References 36 publications

Livestock-Associated MRSA in Household Members of Pig Farmers: Transmission and Dynamics of Carriage, A Prospective Cohort Study

Livestock-Associated MRSA in Household Members of Pig Farmers: Transmission and Dynamics of Carriage, A Prospective Cohort Study

Transmission and Persistence of Livestock-Associated Methicillin-Resistant Staphylococcus aureus among Veterinarians and Their Household Members

Methicillin-resistant Staphylococcus aureus among animals: current overview

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