Abstract
BackgroundIn recent years, livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) multi locus sequence type CC398 has spread widely in the livestock production in Europe. The rates of LA-MRSA in hospitals have been found to be largely determined by contact to and density of livestock in the area.MethodsThis is a cross sectional study of the prevalence of LA-MRSA among hospital staff in a Danish hospital situated in a livestock production region. We analysed nasal swabs, air and dust samples for the presence of MRSA using PCR and mass spectrometry.ResultsOf 1745 employees, 545 (31%) contributed nasal swabs. MRSA was not detected in any participant, nor was it detected in air or dust at the hospital or in houses of employees living on farms. Four percent of the participants had contact to pigs either directly or through household members. LA-MRSA was detected in two of 26 samples from animal sheds, both of them from pig farms. The participation rate was relatively low, but participants were representative for the source population with regards to animal contact and job titles.ConclusionsThe study suggests a low point prevalence of LA-MRSA carriage in Danish hospital staff even in regions where livestock production is dense. Should more studies confirm our findings we see no need for additional hospital precautions towards LA-MRSA in Denmark at the moment. We think that our data might reduce potential stigmatization of hospital workers with contact to LA-MRSA positive farms at their work places and in their communities.
Highlights
In recent years, livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) multi locus sequence type clonal complex 398 (CC398) has spread widely in the livestock production in Europe
The prevalence of staff having a household member working as farmer (6.7%) was as expected according to the estimated proportion from Statistics Denmark of hospital employees with a household member working in agriculture of 6.0% (p = 0.28)
We believe that the lack of LA-MRSA in samples taken at the hospital is not due to limited contact of staff with farms
Summary
Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) multi locus sequence type CC398 has spread widely in the livestock production in Europe. Since the 1980s and with continuous updates, the Netherlands and Denmark have implemented so-called ‘search and destroy’ policies, to prevent transmission of any MRSA into hospitals and other healthcare facilities [16] This strategy has been highly successful with very low incidences of MRSA infections in Danish and Dutch hospitals [16]. The incidence of LA-MRSA carriage in Dutch healthcare workers with direct or indirect contact to pig or veal calves was shown to be low (1.7%). In light of the Dutch observations, that transmission of LA-MRSA by healthcare workers with livestock contact could not be excluded, we wanted to measure the point prevalence of LA-MRSA among hospital staff members in a Danish rural region with high pig density. We wanted to analyse for the effect of the Danish “search and destroy” policy by measuring any MRSA in dust samples in the hospital environment
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