Prevalence of and risk factors associated with MRSA-ST398 carriage in 1872 (response 70%) farmers and neighbouring residents in a pig- and poultry-dense area in Germany were investigated using a cross-sectional study and self-sampling nasal swabs. In the population, 1% without occupational livestock contact and 24% with occupational livestock contact tested positive for MRSA-ST398. The group without occupational livestock contact was 3·8 times [95% confidence interval (CI) 1·5-9·3] more likely to be colonized if a household member had livestock contact and 3·2 times (95% CI 1·4-7·4) more likely if they regularly made private farm visits (e.g. to buy eggs or milk). In the group with occupational livestock contact, pig contact had an odds ratio of 7·1 (95% CI 2·9-17·2) for MRSA-ST398 acquisition. This is the first study to associate private farm visits with acquisition of MRSA; more research to explore the exact transmission routes is necessary.

STEC O104:H4 is usually eliminated from the human gut after 1 month, but may sometimes be excreted for several months. Proper follow-up of infected patients is important to avoid further pathogen spread.

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We investigated a cluster of shiga toxin-producing Escherichia coli (STEC) O104:H4 infections after a family party during a large STEC O104:H4 outbreak in Germany. To identify the vehicle we conducted a retrospective cohort study. Stool samples of party guests, and food and environmental samples from the catering company were tested for STEC. We defined cases as party guests with gastrointestinal symptoms and laboratory-confirmed STEC infection. We found 23 cases among 71 guests. By multivariable analysis consumption of salmon [odds ratio (OR) 15, 95% confidence interval (CI) 2.3-97], herb cream (OR 6.5, 95% CI 1.3-33) and bean salad (OR 6.1, 95% CI 1.4-26) were associated with STEC infection. STEC O104:H4 was detected in samples of bell pepper and salmon. The food handler developed STEC infection. Our results point towards transmission via several food items contaminated by a food handler. We recommend regular education of food handlers emphasizing their role in transmitting infectious diseases.

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