MRSA colonization and infection among persons with occupational livestock exposure in Europe: Prevalence, preventive options and evidence
MRSA colonization and infection among persons with occupational livestock exposure in Europe: Prevalence, preventive options and evidence
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DOI：
10.1016/j.vetmic.2015.10.027
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发表时间：
2017-02-01
影响因子：
3.3
通讯作者：
Koeck, Robin
中科院分区：
文献类型：
--
作者：
Goerge, Tobias;Lorenz, Marthe Barbara;Koeck, Robin
与家畜相关的耐甲氧西林金黄色葡萄球菌(LA-MRSA)在职业接触猪、牛或家禽的人中定居的情况非常频繁。在欧洲，LA-MRSA大多属于克隆谱系CC398。由于被殖民的人患上MRSA感染的风险增加，确定LA-MRSA CC398引起的工作相关感染的负担是暴露人员、保险公司和感染控制人员感兴趣的。本文总结了由LA-MRSA CC398引起的职业相关感染的类型、发病率以及潜在的预防策略，并确定了12例家畜接触者感染的病例报告。总体而言，缺乏描述因耐甲氧西林金黄色葡萄球菌CC398引起的职业相关感染发生率的数据。目前，没有关于防止LA-MRSA CC398在常规接触人群中定植的具体指导意见。在体外，MRSA CC398菌株对莫匹罗星敏感(95%)。单一报告描述了携带LA-MRSA CC398的人的有效非殖民化，但在持续接触牲畜的情况下，长期成功率很低。总体而言，LA-MRSA CC398造成的职业健康风险尚未得到很好的了解。目前，人类LA-MRSA CC398感染的预防主要基于在选择性医疗干预之前进行筛查和非殖民化治疗的建议，以避免医院感染，但没有确凿证据表明可以采取具体措施来预防社区获得性感染。(C)2015爱思唯尔B.V.保留所有权利。
Colonization with livestock-associated Methicillin-resistant Staphylococcusaureus (LA-MRSA) among persons occupationally exposed to pigs, cattle or poultry is very frequent. In Europe, LA-MRSA mostly belong to the clonal lineage CC398. Since colonized persons have an increased risk of developing MRSA infections, defining the burden of work-related infection caused by LA-MRSA CC398 is of interest to exposed personnel, insurance companies and infection control staff. This review summarizes data on the types of occupation-related infections caused by LA-MRSA CC398, the incidence of such infections as well as potential preventive strategies.We identified twelve case reports on infections among livestock-exposed persons. Overall, there is a lack of data describing the incidence of occupation-related infections due to MRSA CC398. Currently, no specific guidance towards the prevention of LA-MRSA CC398 colonization of persons with routine exposure exists. In vitro, MRSA CC398 strains are susceptible (>95%) to mupirocin. Single reports have described effective decolonization of persons carrying LA-MRSA CC398, but long-term success rates are low in case of continuous livestock contact.Overall, the occupational health risk due to LA-MRSA CC398 is not well understood. Currently, prevention of human LA-MRSA CC398 infection is mostly based on the recommendation to perform screening and decolonization therapies prior to elective medical interventions in order to avoid nosocomial infections, but there is no conclusive evidence to perform specific measures aiming to forestall community-acquired infections. (C) 2015 Elsevier B.V. All rights reserved.