Transmission of Methicillin-Resistant Staphylococcus aureus to Human Volunteers Visiting a Swine Farm.
Transmission of Methicillin-Resistant Staphylococcus aureus to Human Volunteers Visiting a Swine Farm.
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DOI：
10.1128/aem.01489-17
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发表时间：
2017-12-01
影响因子：
4.4
通讯作者：
Larsen AR
中科院分区：
文献类型：
--
作者：
Angen Ø;Feld L;Larsen J;Rostgaard K;Skov R;Madsen AM;Larsen AR
耐甲氧西林金黄色葡萄球菌（MRSA）从动物到人类的传播是非常令人关注的，因为它对人类健康和医疗保健系统的影响。目的是研究人类志愿者在猪场短期暴露后MRSA携带的频率和持续时间。该实验研究包括34名志愿者在MRSA阳性猪场中停留1小时，共进行了4次试验。在其中两项试验中，使用交叉设计研究了涉及猪接触的农场工作的影响。在不同时间点测量鼻拭子、咽拭子和空气样本中的MRSA数量，并分析相关协变量。这项调查显示，总体而言，94%的志愿者在农场访问期间获得了MRSA。在志愿者离开马厩两小时后，95%的样本中的鼻腔MRSA计数下降到无法定量的水平。48小时后，94%的志愿者为MRSA阴性。鼻腔MRSA携带与个人暴露于空气中MRSA和农场工作（涉及猪接触）呈正相关，与吸烟呈负相关。MRSA携带与面部触摸行为、鼻甲氧西林敏感金黄色葡萄球菌（MSSA）携带、年龄或性别之间没有观察到相关性。在与猪接触的志愿者中，人MRSA携带的增加似乎取决于周围空气中MRSA浓度的增加，而不是直接与猪的身体接触。在所有咽喉样本中均未检测到MRSA。重要性实验方法使得阐明猪场空气中MRSA水平和农场工作对鼻腔MRSA携带的贡献成为可能。短期暴露于空气中的MRSA对农场游客成为鼻携带者构成了很大的风险，但运输通常在几小时到几天内被清除。短期访问者引起MRSA二次传播的风险很可能可以忽略不计，因为观察到95%的鼻样本仅在2小时后就下降到无法量化的水平。鼻子中的MRSA负荷与空气中的MRSA量高度相关，降低空气中MRSA水平的干预措施或使用口罩可能会减少鼻腔污染。
Transmission of methicillin-resistant Staphylococcus aureus (MRSA) from animals to humans is of great concern due to the implications for human health and the health care system. The objective was to investigate the frequency and duration of MRSA carriage in human volunteers after a short-term exposure in a swine farm. The experimental study included 34 human volunteers staying 1 h in a MRSA-positive swine farm in four trials. In two of the trials, the influence of farm work involving pig contact was studied using a crossover design. The quantities of MRSA in nasal swabs, throat swabs, and air samples were measured at different time points and analyzed in relation to relevant covariates. This investigation showed that, overall, 94% of the volunteers acquired MRSA during the farm visit. Two hours after the volunteers left the stable, the nasal MRSA count had declined to unquantifiable levels in 95% of the samples. After 48 h, 94% of the volunteers were MRSA-negative. Nasal MRSA carriage was positively correlated to personal exposure to airborne MRSA and farm work involving pig contact and negatively correlated to smoking. No association was observed between MRSA carriage and face touching behavior, nasal methicillin-susceptible Staphylococcus aureus (MSSA) carriage, age, or gender. The increase in human MRSA carriage among the volunteers with pig contact seems to be dependent on the increased concentration of airborne MRSA of the surrounding air and not directly on physical contact with pigs. MRSA was not detected in any of the throat samples. IMPORTANCE The experimental approach made it possible to elucidate the contributions of airborne MRSA levels and farm work to nasal MRSA carriage in a swine farm. Short-term exposure to airborne MRSA poses a substantial risk for farm visitors to become nasal carriers, but the carriage is typically cleared within hours to a few days. The risk for short-term visitors to cause secondary transmissions of MRSA is most likely negligible due to the observed decline to unquantifiable levels in 95% of the nasal samples after only 2 h. The MRSA load in the nose was highly correlated to the amount of MRSA in the air and interventions to reduce the level of airborne MRSA or the use of face masks might consequently reduce nasal contamination.