Evaluation of Methicillin-Resistant Staphylococcus aureus Carriage and High Livestock Production Areas in North Carolina through Active Case Finding at a Tertiary Care Hospital
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Date
2019-09-14
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Authors
Feingold, Beth J.
Augustino, Kerri L.
Curriero, Frank C.
Udani, Paras C.
Ramsey, Keith M.
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Abstract
: Recent reports from the Netherlands document the emergence of novel multilocus sequence
typing (MLST) types (e.g., ST-398) of methicillin-resistant Staphylococcus aureus (MRSA) in livestock,
particularly swine. In Eastern North Carolina (NC), one of the densest pig farming areas in the United
States, as many as 14% of MRSA isolates from active case finding in our medical center have no
matches in a repetitive sequence-based polymerase chain reaction (rep-PCR) library. The current
study was designed to determine if these non-matched MRSA (NM-MRSA) were geographically
associated with exposure to pig farming in Eastern NC. While residential proximity to farm waste
lagoons lacked association with NM-MRSA in a logistic regression model, a spatial cluster was
identified in the county with highest pig density. Using MLST, we found a heterogeneous distribution
of strain types comprising the NM-MRSA isolates from the most pig dense regions, including ST-5
and ST-398. Our study raises the warning that patients in Eastern NC harbor livestock associated
MRSA strains are not easily identifiable by rep-PCR. Future MRSA studies in livestock dense areas in
the U.S. should investigate further the role of pig–human interactions.
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DOI
10.3390/ijerph16183418