Low Incidence of Livestock-Associated Methicillin-Resistant Staphylococcus aureus Bacteraemia in The Netherlands in 2009

Brigitte A G L Van Cleef,Jan A J W Kluytmans,Birgit H B Van Benthem,Jos Monen,Thijs Bosch,Anja P J Haenen,Tara C Smith

doi:10.1371/journal.pone.0073096

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) is a worldwide problem in both hospitals and communities all over the world. In 2003, a new MRSA clade emerged with a reservoir in pigs and veal calves: livestock-associated MRSA (LA-MRSA). We wanted to estimate the incidence of bacteraemias due to LA-MRSA using national surveillance data from 2009 in the Netherlands. We found a low incidence of LA-MRSA and MRSA bacteraemia episodes, compared to bacteraemias caused by all S. aureus (0.04, 0.18 and 19.3 episodes of bacteraemia per 100,000 inhabitants per year, respectively). LA-MRSA and MRSA were uncommon compared to numbers from other countries as well. MRSA in general and LA-MRSA in specific does not appear to be a public health problem in the Netherlands now. The low incidence of LA-MRSA bacteraemia episodes may best be explained by differences in the populations affected by LA-MRSA versus other MRSA. However, reduced virulence of the strain involved, and the effectiveness of the search and destroy policy might play a role as well.

Highlights

Methicillin-resistant Staphylococcus aureus (MRSA) is a worldwide problem in both hospitals and communities all over the world
We wanted to estimate the current incidence of severe infections due to livestock-associated MRSA (LA-MRSA) using a national surveillance database in the Netherlands
This observational study was based on data from the national antibiotic resistance surveillance system (ISIS-AR, www.rivm.nl/cib/themas/isis-ar) which included data from participating microbiological laboratories, and the national MRSA surveillance program, where index strains are collected from newly recognized MRSA carriers and/or MRSA infections all over the Netherlands [13]

Summary

Introduction

Methicillin-resistant Staphylococcus aureus (MRSA) is a worldwide problem in both hospitals and communities all over the world. In 2003, a new MRSA clade with a reservoir in pigs and veal calves emerged: so called livestock-associated MRSA (LAMRSA) [2]. High prevalences of LA-MRSA carriage are found in persons in close contact with pigs and veal calves (around 30%) [3,4]. Severe infections have been described occasionally [5] and a few outbreaks have been reported [6,7,8].

Methods

Results

Discussion

Study limitations

Conclusion