Impact of livestock-associated MRSA in a hospital setting

Antimicrobial Resistance and Infection Control

Peter M Schneeberger¹  Sabine C de Greeff²  Sander Leenders¹  Nynke Nagtzaam¹  Maria Janssen¹  Maurine A Leverstein van Hall³  Nienke van de Sande-Bruinsma² 

[1]Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, ‘s-Hertogenbosch 5200 ME, The Netherlands

[2]Center for Infectious Disease Control, Epidemiology and Surveillance, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands

[3]Department of Medical Microbiology and Infection Control, Bronovo Hospital, The Hague, The Netherlands

关键词: Carriage;    Infection control;    MRSA;   

Others  :  1183516
DOI  :  10.1186/s13756-015-0053-8

 received in 2013-10-10, accepted in 2015-03-24,  发布年份 2015

【 摘 要 】

Objectives

The Netherlands is known for a stringent search and destroy policy to prevent spread of MRSA. In the hospital setting, livestock-associated MRSA (LA-MRSA) is frequently found in patients coming from the high density farming area in the south of the Netherlands. The aim of the study was to determine the contribution of LA-MRSA in the epidemiology of MRSA in cases found following the Dutch search and destroy policy.

Patients and methods

From two hospitals serving a population of 550,000 persons all data on MRSA cultures and subsequent control measures from 2008 and 2009 were retrospectively collected and analyzed.

Results

A total of 3856 potential index patients were screened for MRSA, 373 (9.7%) were found to be positive, 292 ( 78%) LA-MRSA and 81 (22%) non-LA-MRSA respectively. No secondary cases were found among contact research in persons exposed to LA-MRSA (0/416), whereas similar contact research for non-LA-MRSA resulted in 83 (2.5%) secondary cases. LA-MRSA were rarely found to cause infections.

Conclusions

LA-MRSA is more prevalent than non-LA-MRSA in Dutch Hospitals in the South of the Netherlands. However, retrospectively studied cases show that the transmission rate for LA-MRSA was much lower than for non-LA-MRSA. This suggest that infection control practices for LA-MRSA may possibly be less stringent than for non-LA-MRSA.

【 授权许可】

   
2015 van de Sande-Bruinsma et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Nethmap. www.SWAB.nl.
• [2]Cuny C, Nathaus R, Layer F, Strommenger B, Altmann D, Witte W. Nasal colonization of humans with methicillin-resistant Staphylococcus aureus (MRSA) CC398 with and without exposure to pigs. PLoS One. 2009; 4(8):e6800.
• [3]Huijsdens XW, van Dijke BJ, Spalburg E, van Santen-Verheuvel MG, Heck ME, Pluister GN et al.. Community-acquired MRSA and pig-farming. Ann Clin Microbiol Antimicrob. 2006; 5:26. BioMed Central Full Text
• [4]Huijsdens XW, Bosch T, van Santen-Verheuvel MG, Spalburg E, Pluister GN, van Luit M, et al. Molecular characterisation of PFGE non-typable methicillin-resistant Staphylococcus aureus in The Netherlands, 2007. Euro Surveill. 2009;14(38).
• [5]Khanna T, Friendship R, Dewey C, Weese JS. Methicillin resistant Staphylococcus aureus colonization in pigs and pig farmers. Vet Microbiol. 2008; 128(3–4):298-303.
• [6]Van Cleef BA, Broens EM, Voss A, Huijsdens XW, Zuchner L, Van Benthem BH et al.. High prevalence of nasal MRSA carriage in slaughterhouse workers in contact with live pigs in The Netherlands. Epidemiol Infect. 2010; 138(5):756-63.
• [7]Kluytmans JA. Methicillin-resistant Staphylococcus aureus in food products: cause for concern or case for complacency? Clin Microbiol Infect. 2010; 16(1):11-5.
• [8]de Boer E, Zwartkruis-Nahuis JT, Wit B, Huijsdens XW, de Neeling AJ, Bosch T et al.. Prevalence of methicillin-resistant Staphylococcus aureus in meat. Int J Food Microbiol. 2009; 134(1–2):52-6.
• [9]van Loo IH, Diederen BM, Savelkoul PH, Woudenberg JH, Roosendaal R, van Belkum A et al.. Methicillin resistant Staphylococcus aureus in meat products, the Netherlands. Emerg Infect Dis. 2007; 13(11):1753-5.
• [10]van Rijen MM, Bosch T, Verkade EJ, Schouls L, Kluytmans JA. Livestock-associated MRSA carriage in patients without direct contact with livestock. PLoS One. 2014; 9(6):e100294.
• [11]Wulf MW, Markestein A, van der Linden FT, Voss A, Klaassen C, Verduin CM. 242 First outbreak of methicillin-resistant Staphylococcus aureus ST398 in a Dutch hospital, June 2007. Euro Surveill. 2008;13(9).
• [12]Bhat GK, Jathana LS, Kumar A. Phenotypic expression of methicillin resistance in nosocomial Staphylococcus aureus. Indian J Med Microbiol. 2008; 26(4):398-9.
• [13]Fanoy E, Helmhout LC, van der Vaart WL, Weijdema K, van Santen-Verheuvel MG, Thijsen SF, et al. An outbreak of non-typeable MRSA within a residential care facility. Euro Surveill. 2009;14(1).
• [14]Golding GR, Bryden L, Levett PN, McDonald RR, Wong A, Wylie J et al.. Livestock-associated methicillin resistant Staphylococcus aureus sequence type 398 in humans, Canada. Emerg Infect Dis. 2010; 16(4):587-94.
• [15]Mammina C, Cala C, Plano MR, Bonura C, Vella A, Monastero R et al.. Ventilator-associated pneumonia and MRSA ST398, Italy. Emerg Infect Dis. 2010; 16(4):730-1.
• [16]van Rijen MM, Kluytmans JA. Costs and benefits of the MRSA Search and Destroy policy in a Dutch hospital. Eur J Clin Microbiol Infect Dis. 2009; 28(10):1245-52.
• [17]Bootsma MC, Wassenberg MW, Trapman P, Bonten MJ. The nosocomial transmission rate of animal associated ST398 meticillin-resistant Staphylococcus aureus. J R Soc Interface. 2011; 8(57):578-84.
• [18]Hetem DJ, Bootsma MC, Troelstra A, Bonten MJ. Transmissibility of livestock-associated methicillin-resistant Staphylococcus aureus. Emerg Infect Dis. 2013; 19(11)):1797-802.
• [19]van Cleef BA, Graveland H, Haenen AP, van de Giessen AW, Heederik D, Wagenaar JA et al.. Persistence of livestock-associated methicillin-resistant Staphylococcus aureus in field workers after short-term occupational exposure to pigs and veal calves. J Clin Microbiol. 2011; 49(3):1030-3.
• [20]Slingerland BC, Tavakol M, McCarthy AJ, Lindsay JA, Snijders SV, Wagenaar JA et al.. Survival of Staphylococcus aureus ST398 in the human nose after artificial inoculation. PLoS One. 2012; 7(11)):e48896.
• [21]Wulf MW, Markestein A, van der Linden FT, Voss A, Klaassen C, Verduin CM. First outbreak of methicillin-resistant Staphylococcus aureus ST398 in a Dutch hospital. 2007. Euro Surveill. 2008;13(9).
• [22]Verkade E, Bosch T, Hendriks Y, Kluytmans J. Outbreak of methicillin-resistant Staphylococcus aureus ST398 in a Dutch nursing home. Infect Control Hosp Epidemiol. 2012; 33(6):624-6.
• [23]Monecke S, Kuhnert P, Hotzel H, Slickers P, Ehricht R. Microarray based study on virulence-associated genes and resistance determinants of Staphylococcus aureus isolates from cattle. Vet Microbiol. 2007; 125(1–2):128-40.
• [24]Sergio DM, Koh TH, Hsu LY, Ogden BE, Goh AL, Chow PK. Investigation of meticillin-resistant Staphylococcus aureus in pigs used for research. J Med Microbiol. 2007; 56(Pt 8):1107-9.
• [25]Lewis HC, Molbak K, Reese C, Aarestrup FM, Selchau M, Sorum M et al.. Pigs as source of methicillin resistant Staphylococcus aureus CC398 infections in humans, Denmark. Emerg Infect Dis. 2008; 14(9):1383-9.
• [26]van Duijkeren E, Houwers DJ, Schoormans A, Broekhuizen-Stins MJ, Ikawaty R, Fluit AC et al.. Transmission of methicillin-resistant Staphylococcus intermedius between humans and animals. Vet Microbiol. 2008; 128(1-2):213-5.
• [27]van Belkum A, Melles DC, Peeters JK, van Leeuwen WB, van Duijkeren E, Huijsdens XW et al.. Methicillin-resistant and -susceptible Staphylococcus aureus sequence type 398 in pigs and humans. Emerg Infect Dis. 2008; 14(3):479-83.
• [28]de Jonge R, Verdier JE, Havelaar AH. Prevalence of meticillin-resistant Staphylococcus aureus amongst professional meat handlers in the Netherlands, March-July 2008. Euro Surveill. 2010;15(46).
• [29]Busscher JF, van Duijkeren E, Sloet van Oldruitenborgh-Oosterbaan S. The prevalence of methicillin resistant staphylococci in healthy horses in the Netherlands. Vet Microbiol. 2006; 113(1–2):131-6.
• [30]Baptiste KE, Williams K, Willams NJ, Wattret A, Clegg PD, Dawson S et al.. Methicillin-resistant staphylococci in companion animals. Emerg Infect Dis. 2005; 11(12):1942-4.
• [31]Vengust M, Anderson ME, Rousseau J, Weese JS. Methicillin-resistant staphylococcal colonization in clinically normal dogs and horses in the community. Lett Appl Microbiol. 2006; 43(6):602-6.
• [32]Weese JS, Rousseau J, Traub-Dargatz JL, Willey BM, McGeer AJ, Low DE. Community-associated methicillin-resistant Staphylococcus aureus in horses and humans who work with horses. J Am Vet Med Assoc. 2005; 226(4):580-3.
• [33]van Duijkeren E, Ten Horn L, Wagenaar JA, de Bruijn M, Laarhoven L, Verstappen K et al.. Suspected Horse-to-Human Transmission of MRSA ST398. Emerg Infect Dis. 2011; 17(6):1137-9.
• [34]Lekkerkerk WSN, van de Sande-Bruinsma N, van der Sande MAB, Tjon-A-Tsien A, Groenheide A, Haenen A, et al. Emergence of MRSA of unknown origin in the Netherlands. Clin Microbiol Infect. 2011. doi:28810.1111/j.1469-0691.2011.03662.x.