Face Mask Use and Persistence of Livestock-associated Staphylococcus aureus Nasal Carriage among Industrial Hog Operation Workers and Household Contacts, USA
Face Mask Use and Persistence of Livestock-associated Staphylococcus aureus Nasal Carriage among Industrial Hog Operation Workers and Household Contacts, USA
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DOI：
10.1289/ehp3453
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发表时间：
2018-12-01
影响因子：
10.4
通讯作者：
Heaney, Christopher D.
中科院分区：
文献类型：
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作者：
Nadimpalli, Maya L.;Stewart, Jill K.;Heaney, Christopher D.
背景：工业养猪场（IHO）工人的鼻腔中可能持续携带与牲畜相关的抗生素耐药性金黄色葡萄球菌。目前尚不清楚 IHO 工作活动是否会改变 IHO 工作人员及其家庭成员对这些细菌的接触。 目的：我们的目的是调查 IHO 工作活动与 IHO 工作人员及其家庭成员中持续存在抗生素耐药性、家畜相关的金黄色葡萄球菌鼻腔携带的关系。方法：在 4 个月内，每两周一次，IHO 工作人员及其家庭成员完成 调查问卷并提供鼻拭子，评估金黄色葡萄球菌、多重耐药金黄色葡萄球菌 (MDRSA) 和牲畜相关标记物（四环素耐药性、scn 缺失、spa 类型）。我们研究了短暂和习惯性 IHO 工作活动与金黄色葡萄球菌鼻腔携带结果之间的关联。结果：101 名 IHO 工作人员和 79 名家庭成员完成了 1,456 次研究访问。使用口罩（每增加 25%）与 MDRSA 鼻腔携带几率降低相关（比值比 [OR]：0.65 [95% 置信区间 (CI)：0.46, 0.92]、四环素耐药金黄色葡萄球菌 [OR = 0.74 (95% CI: 0.56, 0.97)] 和金黄色葡萄球菌克隆复合物 (CC) 398/CC9 [OR = 0.77（95% CI：0.60，0.99）]。曾经（与从未）给猪注射过的 IHO 工作人员出现这些结果的几率更高。在家庭成员中，与始终（> 80％的时间）使用口罩的 IHO 工作人员一起生活，而不是有时或从不使用口罩，与携带 scn 阴性金黄色葡萄球菌、四环素抗性金黄色葡萄球菌、 和金黄色葡萄球菌 CC398/CC9（OR 范围：0.12-0.20，所有 p < 0.05），并且持续使用 IHO 工作服仅与家庭成员携带 MDRSA 的几率降低相关。与习惯性接触超过 4,000 头生猪的 IHO 工作人员住在一起（对比 4,000 头生猪）
BACKGROUND: Industrial hog operation (IHO) workers may persistently carry antibiotic-resistant, livestock-associated Staphylococcus aureus in their nasal cavities. It is unclear whether IHO work activities can alter IHO workers' and their household members' exposure to these bacteria.OBJECTIVE: Our objective was to investigate the relationship of IHO work activities with persistence of antibiotic-resistant, livestock-associated S. aureus nasal carriage among IHO workers and their household members.METHODS: At biweekly intervals over 4 months, IHO workers and their household members completed questionnaires and provided nasal swabs that were assessed for S. aureus, multidrug-resistant S. aureus (MDRSA), and livestock-associated markers (tetracycline resistance, scn absence, spa type). We examined the association between transient and habitual IHO work activities and S. aureus nasal carriage outcomes.RESULT: One hundred one IHO workers and 79 household members completed 1,456 study visits. Face mask use (each 25% increase) was associated with reduced odds of nasal carriage of MDRSA (odds ratio [OR]: 0.65 [95% confidence interval (CI): 0.46, 0.92], tetracycline-resistant S. aureus [OR = 0.74 (95% CI: 0.56, 0.97)], and S. aureus clonal complex (CC) 398/CC9 [OR = 0.77 (95% CI: 0.60, 0.99)]. IHO workers who ever (vs. never) gave pigs injections had higher odds of these outcomes. Among household members, living with an IHO worker who consistently (>80% of the time) versus sometimes or never used a face mask was associated with reduced odds of carrying scn-negative S. aureus, tetracycline-resistant S. aureus, and S. aureus CC398/CC9 (OR range: 0.12-0.20, all p < 0.05), and consistent IHO worker coveralls use was associated with reduced odds of household member MDRSA carriage only. Living with an IHO worker who habitually had contact with >4,000 hogs (vs.