Acquisition Risk Factors of the SCCmec IX-Methicillin-Resistant Staphylococcus aureus in Swine Production Personnel in Chiang Mai and Lamphun Provinces, Thailand.

Peerapat Rongsanam,Decha Tamdee,Terdsak Yano,Panuwat Yamsakul,Ratchadaporn Udpaun,Usanee Anukool,Wuttipong Yokart,Suweera Sutammeng,Duangporn Pichpol

doi:10.3390/antibiotics9100651

Peerapat Rongsanam, Decha Tamdee + Show 7 more

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https://doi.org/10.3390/antibiotics9100651

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Journal: Antibiotics	Publication Date: Sep 29, 2020
Citations: 4	License type: CC BY 4.0

Affiliation: Chiang Mai University

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) harboring the type-IX staphylococcal cassette chromosome mec (SCCmec) has been found in pigs and humans in Northern Thailand. However, knowledge of the prevalence and acquisition risk factors of this MRSA strain among swine production personnel (SPP) are needed. The nasal swab samples and data were collected from 202 voluntary SPP and 31 swine farms in Chiang Mai and Lamphun Provinces, Thailand in 2017. MRSA were screened and identified using mannitol salt agar, biochemical and antimicrobial susceptibility testing, multiplex PCR, and the SCCmec typing. The prevalence of MRSA was 7.9% (16/202) and 19.3% (6/31) among SPP and swine farms. All isolates were multidrug-resistant, and 55 of 59 isolates (93%) contained the type-IX SCCmec element. Data analysis indicated that education, working time, contact frequency, working solely with swine production, and personal hygiene were significantly related to MRSA acquisition (p < 0.05). The multivariate analysis revealed that pig farming experience, working days, and showering were good predictors for MRSA carriage among SPP (area under the curve (AUC) = 0.84). The biosecurity protocols and tetracycline use were significantly associated with MRSA detection in pig farms (p < 0.05). Hence, the active surveillance of MRSA and further development of local/national intervention for MRSA control are essential.

Highlights

Methicillin-resistant Staphylococcus aureus (MRSA) is resistant to all beta-lactam antibiotics except ceftaroline
The cefoxitin disk test and multiplex PCR at last confirmed the MRSA phenotype and genotype of 59 S. aureus isolates from 16 swine production personnel (SPP)
The MRSA carriage rate among SPP was calculated at 7.9% (16/202)

Summary

Introduction

Methicillin-resistant Staphylococcus aureus (MRSA) is resistant to all beta-lactam antibiotics except ceftaroline. The hospital-associated (HA-) MRSA is typically resistant to multiple classes of antibiotics; infections caused by MRSA usually result in prolonged hospitalization, extensive treatment, and a high economic burden. MRSA was reported in patients who do not have common healthcare risk factors (e.g., previous surgery or history of hospital admission) in the late 1980s, and it was categorized as community-associated (CA-) MRSA [1,2]. In 2005, previous studies in France and the Netherlands provided evidence of a novel lineage of MRSA in pigs and pig farmers, clonal complex (CC) 398, which is recognized as the livestock-associated MRSA (LA-MRSA) [3,4]. Several studies demonstrated the prevalence and MRSA-associated risk factors among

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