Nasal Colonization of Humans with Methicillin-Resistant Staphylococcus aureus (MRSA) CC398 with and without Exposure to Pigs 英文参考文献.docVIP

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Nasal Colonization of Humans with Methicillin-Resistant Staphylococcus aureus (MRSA) CC398 with and without Exposure to Pigs 英文参考文献.doc

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Nasal Colonization of Humans with Methicillin-Resistant Staphylococcus aureus (MRSA) CC398 with and without Exposure to Pigs 英文参考文献

NasalColonizationofHumanswithMethicillin-Resistant Staphylococcusaureus(MRSA)CC398withandwithout ExposuretoPigs ChristianeCuny1,RolfNathaus3,FranziskaLayer1,BirgitStrommenger1,DorisAltmann2 ,Wolfgang Witte1* 1Robert Koch Institute, Wernigerode Branc, Wernigerode, Germany, 2Robert Koch Institute, Division of Epidemiology, Berlin, Germany, 3Rolf Nathaus, Veterinary Practice,Reken,Germany Abstract Background:StudiesinseveralEuropeancountriesandinNorthAmericarevealedafrequentnasalcolonizationoflivestock withMRSACC398andalsoinhumanswithdirectprofessionalexposuretocolonizedanimals.Thestudypresentedhere addressesthequestionoffurthertransmissiontononexposedhumans. Methods:Afterselecting47farmswithcolonizedpigsindifferentregionsofGermanywesampledthenaresof113humans working daily with pigs and of their 116 non exposed family members. The same was performed in 18 veterinarians attending pig farms and in 44 of their non exposed family members. For investigating transmission beyond families we samplesthenaresof462pupilsattendingasecondaryschoolinahighdensitypigfarmingarea.MRSAweredetectedby direct culture on selective agar. The isolates were typed by means of spa-sequence typing and classification of SCCmec elements.Forattributionofspasequencetypestoclonallineagesasdefinedbymultilocussequencetypingweusedthe BURPalgorithm.Antibioticsusceptibilitytestingwasperformedbymicrobrothdilutionassay. Results: Atthe farms investigated 86% of humansexposed and only4.3% of their family members were found tocarry MRSA exhibiting spa-types corresponding to clonal complex CC398. Nasal colonization was also found in 45% of veterinarians caring for pig farms and in 9% of their non exposed family members. Multivariate analysis revealed that antibioticusagepriortosamplingbeardnoriskwithrespecttocolonization.From462pupilsonly3werefoundcolonized, all3werelivingonpigfarms. Conclusion:TheseresultsindicatethatsofarthedisseminationofMRSACC398tononexposedhumansisinfrequentand probablydoesnotreachbeyondfa