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. 2014 Jun 27;9(6):e100294.
doi: 10.1371/journal.pone.0100294. eCollection 2014.

Livestock-associated MRSA carriage in patients without direct contact with livestock

Miranda M L van Rijen  1 , Thijs Bosch  2 , Erwin J M Verkade  3 , Leo Schouls  2 , Jan A J W Kluytmans  4 ; CAM Study Group
Collaborators, Affiliations

Livestock-associated MRSA carriage in patients without direct contact with livestock

Miranda M L van Rijen et al. PLoS One. .

Abstract

Background: Livestock-associated MRSA (MC398) has emerged and is related to an extensive reservoir in pigs and veal calves. Individuals with direct contact with these animals and their family members are known to have high MC398 carriage rates. Until now it was assumed that MC398 does not spread to individuals in the community without pig or veal calf exposure. To test this, we identified the proportion of MC398 in MRSA positive individuals without contact with pigs/veal calves or other known risk factors (MRSA of unknown origin; MUO).

Methods: In 17 participating hospitals, we determined during two years the occurrence of MC398 in individuals without direct contact with livestock and no other known risk factor (n = 271) and tested in a post analysis the hypothesis whether hospitals in pig-dense areas have higher proportions of MC398 of all MUO.

Results: Fifty-six individuals (20.7%) without animal contact carried MC398. In hospitals with high pig-densities in the adherence area, the proportion of MC398 of all MUO was higher than this proportion in hospitals without pigs in the surroundings.

Conclusions: One fifth of the individuals carrying MUO carried MC398. So, MC398 is found in individuals without contact to pigs or veal calves. The way of transmission from the animal reservoir to these individuals is unclear, probably by human-to-human transmission or by exposure to the surroundings of the stables. Further research is needed to investigate the way of transmission.

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Conflict of interest statement

Competing Interests: The authors confirm that Jan Kluytmans is a PLOS ONE Editorial Board member. This does not alter the authors' adherence to PLOS ONE Editorial policies and criteria.

Figures

Figure 1
Figure 1. Genotypic relatedness of 1020 MRSA isolates represented as a minimum spanning tree based on MLVA types.
Clustering of MLVA profiles was obtained using a categorical coefficient to create a minimum spanning tree in which the MLVA types are displayed as circles. The size of each circle indicates the number of isolates with this particular type. MLVA complexes (MC) are indicated in characters e.g. MC398 denotes MLVA complex 398.
Figure 2
Figure 2. Pig-densities in the Netherlands.
Hospitals with high pig-densities in the adherence areas are presented within the circle.
See this image and copyright information in PMC

References

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