Evaluation of Methicillin-Resistant Staphylococcus aureus Carriage and High Livestock Production Areas in North Carolina through Active Case Finding at a Tertiary Care Hospital
Evaluation of Methicillin-Resistant Staphylococcus aureus Carriage and High Livestock Production Areas in North Carolina through Active Case Finding at a Tertiary Care Hospital
复制标题
DOI：
10.3390/ijerph16183418
复制
发表时间：
2019-09-02
影响因子：
--
通讯作者：
Ramsey, Keith M.
中科院分区：
文献类型：
--
作者：
Feingold, Beth J.;Augustino, Kerri L.;Ramsey, Keith M.
最近来自荷兰的报道记录了新的多位点序列分型（MLST）类型的出现（例如，ST-398）的耐甲氧西林金黄色葡萄球菌（MRSA）的家畜，特别是猪。在东北卡罗来纳州（NC），在美国的一个丹尼森猪养殖区，多达14%的MRSA分离株从活跃的情况下发现在我们的医疗中心没有匹配的重复序列为基础的聚合酶链反应（rep-PCR）库。本研究旨在确定这些不匹配的MRSA（NM-MRSA）是否与北卡罗来纳州东部养猪场的暴露存在地理关联。虽然在逻辑回归模型中，靠近农场废物泻湖的住宅与NM-MRSA缺乏关联，但在猪密度最高的县发现了一个空间集群。使用MLST，我们发现菌株类型的异质分布，包括来自猪最密集区域的NM-MRSA分离株，包括ST-5和ST-398。我们的研究提出了一个警告，即东北卡罗来纳州港口牲畜相关MRSA菌株的患者不容易通过rep-PCR识别。未来在美国牲畜密集地区的MRSA研究应进一步调查猪与人相互作用的作用。
Recent reports from the Netherlands document the emergence of novel multilocus sequence typing (MLST) types (e.g., ST-398) of methicillin-resistant Staphylococcus aureus (MRSA) in livestock, particularly swine. In Eastern North Carolina (NC), one of the densest pig farming areas in the United States, as many as 14% of MRSA isolates from active case finding in our medical center have no matches in a repetitive sequence-based polymerase chain reaction (rep-PCR) library. The current study was designed to determine if these non-matched MRSA (NM-MRSA) were geographically associated with exposure to pig farming in Eastern NC. While residential proximity to farm waste lagoons lacked association with NM-MRSA in a logistic regression model, a spatial cluster was identified in the county with highest pig density. Using MLST, we found a heterogeneous distribution of strain types comprising the NM-MRSA isolates from the most pig dense regions, including ST-5 and ST-398. Our study raises the warning that patients in Eastern NC harbor livestock associated MRSA strains are not easily identifiable by rep-PCR. Future MRSA studies in livestock dense areas in the U.S. should investigate further the role of pig-human interactions.