Swine Farming Is a Risk Factor for Infection With and High Prevalence of Carriage of Multidrug-Resistant Staphylococcus aureus.-猫眼课题宝

DOI：

10.1093/cid/civ234

发表时间：

2015-07

期刊：

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

影响因子：

通讯作者：

中科院分区：

其他

文献类型：

作者：

S. Wardyn;B. Forshey;Sarah A. Farina;A. Kates;R. Nair;Megan K Quick;James Y. Wu;B. Hanson;S. O’Malley;Hannah W. Shows;Ellen M Heywood;L. Beane-Freeman;C. Lynch;Margaret A. Carrel;Tara C. Smith

背景牲畜相关金黄色葡萄球菌（LA-SA）已在世界范围内记录在案。然而，关于LA-SA定殖和感染，特别是在农村环境中，仍有许多未知之处。我们对1342名爱荷华州人进行了一项大规模的前瞻性研究，包括与牲畜接触的个人和一个以社区为基础的对照组。收集鼻和咽拭子以确定入组时的定植，并对17个月以上的皮肤感染拭子进行S。金黄色。结果包括S.金黄色葡萄球菌、耐甲氧西林的S.金黄色葡萄球菌（MRSA）、四环素耐药的S.金黄色葡萄球菌（TRSA）、多药耐药S.金黄色葡萄球菌（MDRSA）和LA-SA。结果在1342名参与者中，351名（26.2%; 95%置信区间[CI]，23.8%-28.6%）携带S。金黄色。在1342名参与者中，34名（2.5%; 95% CI，1.8%-3.5%）分离出MRSA，131名（9.8%; 95% CI，8.3%-11.5%）分离出LA-SA。当前猪暴露的个体携带S.金黄色葡萄球菌（患病率[PR]，1.8; 95% CI，1.4-2.2）、TRSA（PR，8.4; 95% CI，5.6-12.6）、MDRSA（PR，6.1; 95% CI，3.8-10.0）和LA-SA（PR，5.8; 95% CI，3.9-8.4）。67例患者报告了皮肤感染（n = 103），发生率为6.6（95% CI，4.9-8.9）/1000人月。结论：目前的养猪工人携带MDRSA的可能性是没有接触过猪的工人的6倍。我们观察到由LA-SA引起的活动性感染。这一发现表明，与牲畜接触的个体可能有较高的暴露率，并可能感染耐药沙门氏菌。金黄色葡萄球菌菌株，包括LA-SA菌株。

BACKGROUND Livestock-associated Staphylococcus aureus (LA-SA) has been documented worldwide. However, much remains unknown about LA-SA colonization and infection, especially in rural environments. METHODS We conducted a large-scale prospective study of 1342 Iowans, including individuals with livestock contact and a community-based comparison group. Nasal and throat swabs were collected to determine colonization at enrollment, and skin infection swabs over 17 months were assessed for S. aureus. Outcomes included carriage of S. aureus, methicillin-resistant S. aureus (MRSA), tetracycline-resistant S. aureus (TRSA), multidrug-resistant S. aureus (MDRSA), and LA-SA. RESULTS Of 1342 participants, 351 (26.2%; 95% confidence interval [CI], 23.8%-28.6%) carried S. aureus. MRSA was isolated from 34 (2.5%; 95% CI, 1.8%-3.5%) and LA-SA from 131 (9.8%; 95% CI, 8.3%-11.5%) of the 1342 participants. Individuals with current swine exposure were significantly more likely to carry S. aureus (prevalence ratio [PR], 1.8; 95% CI, 1.4-2.2), TRSA (PR, 8.4; 95% CI, 5.6-12.6), MDRSA (PR, 6.1; 95% CI, 3.8-10.0), and LA-SA (PR, 5.8; 95% CI, 3.9-8.4) than those lacking exposure. Skin infections (n = 103) were reported from 67 individuals, yielding an incidence rate of 6.6 (95% CI, 4.9-8.9) per 1000 person-months. CONCLUSIONS Current swine workers are 6 times more likely to carry MDRSA than those without current swine exposure. We observed active infections caused by LA-SA. This finding suggests that individuals with livestock contact may have a high prevalence of exposure to, and potentially infection with, antibiotic-resistant S. aureus strains, including LA-SA strains.

Swine Farming Is a Risk Factor for Infection With and High Prevalence of Carriage of Multidrug-Resistant Staphylococcus aureus.

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