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. 2017 Oct 1;65(7):1072-1076.
doi: 10.1093/cid/cix504.

Emergence of Livestock-Associated Methicillin-Resistant Staphylococcus aureus Bloodstream Infections in Denmark

Jesper Larsen  1 , Andreas Petersen  1 , Anders R Larsen  1 , Raphael N Sieber  1 , Marc Stegger  1   2 , Anders Koch  1 , Frank M Aarestrup  3 , Lance B Price  2   4 , Robert L Skov  1 ; Danish MRSA Study Group
Collaborators, Affiliations

Emergence of Livestock-Associated Methicillin-Resistant Staphylococcus aureus Bloodstream Infections in Denmark

Jesper Larsen et al. Clin Infect Dis. .

Abstract

Background: Livestock-associated methicillin-resistant Staphylococcus aureus clonal complex 398 (LA-MRSA CC398) is causing an increasing number of skin and soft tissue infections (SSTIs) in Denmark and other European countries with industrial pig production. Yet, its impact on MRSA bloodstream infections (BSIs) has not been well studied.

Methods: We investigated the clinical epidemiology of all human cases of LA-MRSA CC398 BSI during 2010-2015. Cases of LA-MRSA CC398 BSI were compared to cases of BSI caused by other types of MRSA and cases of SSTI caused by LA-MRSA CC398. Whole-genome sequence analysis was used to assess the phylogenetic relationship among LA-MRSA CC398 isolates from Danish pigs and cases of BSI and SSTI.

Results: The number of LA-MRSA CC398 BSIs and SSTIs increased over the years, peaking in 2014, when LA-MRSA CC398 accounted for 16% (7/44) and 21% (211/985) of all MRSA BSIs and SSTIs, corresponding to 1.2 and 37.4 cases of BSI and SSTI per 1000000 person-years, respectively. Most patients with LA-MRSA CC398 BSI had no contact to livestock, although they tended to live in rural areas. LA-MRSA CC398 caused 24.3 BSIs per 1000 SSTIs among people with no livestock contact, which is similar to the ratio observed for other types of MRSA. Whole-genome sequence analysis showed that most of the BSI and SSTI isolates were closely related to Danish pig isolates.

Conclusions: This study demonstrates that the increasing number of LA-MRSA CC398 BSIs occurred in parallel with a much larger wave of LA-MRSA CC398 SSTIs and an expanding pig reservoir.

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Figures

Figure 1.
Figure 1.
Temporal trends of livestock-associated methicillin-resistant Staphylococcus aureus CC398 bloodstream infections (BSIs) and skin and soft tissue infections (SSTIs) in Denmark.
Figure 2.
Figure 2.
Part of the maximum-likelihood phylogeny containing the bloodstream infection (BSI) and skin and soft tissue infection (SSTI) isolates (see Supplementary Figure 1 for a full version of the phylogeny, including bootstrap values). Red boxes, BSI isolates; yellow boxes, SSTI isolates; green boxes, Danish pig livestock-associated methicillin-resistant Staphylococcus aureus CC398 isolates, including 6 isolates from the international collection; black boxes, other livestock-associated Staphylococcus aureus CC398 isolates from the international collection. Scale bar represents the number of nucleotide substitutions per site.
See this image and copyright information in PMC

References

    1. Larsen J, Petersen A, Sørum M et al. . Methicillin-resistant Staphylococcus aureus CC398 is an increasing cause of disease in people with no livestock contact in Denmark. Euro Surveill 2015; 20. doi:10.2807/1560-7917.ES.2015.20.37.30021. - PMC - PubMed
    1. van Cleef BA, Monnet DL, Voss A et al. . Livestock-associated methicillin-resistant Staphylococcus aureus in humans, Europe. Emerg Infect Dis 2011; 17:502–5. - PMC - PubMed
    1. EPI-NYT. MRSA CC398-epidemiologien i Danmark. Danish Available at: http://www.ssi.dk/Aktuelt/Nyhedsbreve/EPI-NYT/2014/Uge%2024a%20-%202014..... Accessed 4 April 2016.
    1. Larsen AR, Stegger M, Sørum M. spa typing directly from a mecA, spa and pvl multiplex PCR assay-a cost-effective improvement for methicillin-resistant Staphylococcus aureus surveillance. Clin Microbiol Infect 2008; 14:611–4. - PubMed
    1. Quan H, Li B, Couris CM et al. . Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol 2011; 173:676–82. - PubMed

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