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Livestock-Associated MRSA in Household Members of Pig Farmers: Transmission and Dynamics of Carriage,A Prospective Cohort Study
Authors:Brigitte A G L van Cleef  Birgit H B van Benthem  Erwin J M Verkade  Miranda M L van Rijen  Marjolein F Q Kluytmans-van den Bergh  Haitske Graveland  Thijs Bosch  Koen M H W Verstappen  Jaap A Wagenaar  Marian E H Bos  Dick Heederik  Jan A J W Kluytmans
Abstract:This prospective cohort study describes carriage of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) in household members from 49 farrowing pig farms in the Netherlands (2010–2011). Of 171 household members, 4% were persistent MRSA nasal carriers, and the MRSA prevalence on any given sampling moment was 10% (range 7-11%). Working in the stables (of which 98% was MRSA-positive, prevalence ratio (PR) = 2.11 per 10 hours), working with sows (PR=1.97), and living with an MRSA-positive pig farmer (PR=4.63) were significant determinants for MRSA carriage. Significant protective factors were carriage of methicillin-susceptible Staphylococcus aureus (MSSA) (PR=0.50), and wearing a facemask when working in the stables (37% decreased prevalence). All MRSA strains during the study period were known livestock-associated types. The bacteriophage φ3 was not found in household members. Transmission from pigs and the environment appeared to be important determinants; human-to-human transmission could not sufficiently be differentiated. Wearing a facemask when working in the stables and carriage of MSSA are potential interventional targets.
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