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Emergence of livestock-associated MRSA bloodstream infections in Denmark

Livestock-associated methicillin-resistant Staphylococcus aureus clonal complex 398 (LA-MRSA CC398) is causing an increasing number of skin and soft tissue infections (SSTIs) in Denmark and other European countries with industrial pig production. Yet, its impact on MRSA bloodstream infections (BSIs) has not been well studied.

Friday 14 July 2017 (1 years 8 months 11 days ago)

We investigated the clinical epidemiology of all human cases of LA-MRSA CC398 BSI during 2010–2015. Cases of LA-MRSA CC398 BSI were compared to cases of BSI caused by other types of MRSA and cases of SSTI caused by LA-MRSA CC398. Whole-genome sequence analysis was used to assess the phylogenetic relationship among LA-MRSA CC398 isolates from Danish pigs and cases of BSI and SSTI.

The number of LA-MRSA CC398 BSIs and SSTIs increased over the years, peaking in 2014, where LA-MRSA CC398 accounted for 16% (7/44) and 21% (211/985) of all MRSA BSIs and SSTIs, corresponding to 1.2 and 37.4 cases of BSI and SSTI per 1,000,000 person-years, respectively. Most patients with LA-MRSA CC398 BSI had no contact to livestock, although they tended to live in rural areas. LA-MRSA CC398 caused 24.3 BSIs per 1,000 SSTIs among people with no livestock contact, which is similar to the ratio observed for other types of MRSA. Whole-genome sequence analysis showed that most of the BSI and SSTI isolates were closely related to Danish pig isolates.

This study demonstrates that the increasing number of LA-MRSA CC398 BSIs occurred in parallel with a much larger wave of LA-MRSA CC398 SSTIs and an expanding pig reservoir.

Jesper Larsen, Andreas Petersen, Anders R. Larsen, Raphael N. Sieber, Marc Stegger, Anders Koch, Frank M. Aarestrup, Lance B. Price, Robert L. Skov, the Danish MRSA Study Group; Emergence of livestock-associated methicillin-resistant Staphylococcus aureus bloodstream infections in Denmark. Clin Infect Dis 2017 cix504. doi: 10.1093/cid/cix504

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18-Jul-2017d.burchd.burchI think is is of interest to put this work into some perspective. Alban et al (2017) also from Denmark have also published information on Staphylococcal infections in man and shown that in 2015, 1973 cases of bacteraemia were associated with MSSA, 26 were associated with Non-CC398 MRSA and only 3 cases from CC398 MRSA (0.15%). It is disappointing that there has been such a rapid increase in MRSA positive herds in Denmark to 69% from 3% in 2007 but this has relatively little impact on human health. Most of these cases occur in rural communities rather than towns confirming our own UK FSA (2017) report findings that MRSA contaminated pork products are a very low risk transmitter of infection. Close, possibly intimate relationships with pig farmers may be the cause of spread in rural areas? Regards David
25-Jul-2017TiennghiTiennghiGiá heo???
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