Frequency-risk and duration-risk relations between occupational livestock contact and methicillin-resistant Staphylococcus aureus carriage among workers in Guangdong, China

Ye, Xiaohua; Liu, Weidong; Fan, Yanping; Wang, Xiaolin; Zhou, Jian; Chen, Sidong

doi:10.1016/j.ajic.2015.03.026

Cited by 19 publications

(16 citation statements)

References 30 publications

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“…Our study indicates that the overall pooled prevalence of MRSA nasal colonization among Chinese children is 4.4%, which is much higher than that reported in other countries and areas [ 28 ], but is lower than that in Chinese adults [ 29 , 30 ], which might also indicate that Chinese children are important reservoirs of MRSA and may play a central role in disseminating MRSA in the community and hospital settings. The regional distinctions are also observed by the result of our subgroup analysis stratified by region and supported by the findings of Chen CJ et al [ 21 ], which identified residing in northern Taiwan is a risk factor of MRSA nasal colonization.…”

Section: Discussioncontrasting

confidence: 60%

Methicillin-Resistant Staphylococcus aureus Nasal Colonization in Chinese Children: A Prevalence Meta-Analysis and Review of Influencing Factors

Lin

Yang

et al. 2016

PLoS ONE

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ObjectiveTo determine the pooled prevalence and review the influencing factors of methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization in Chinese children.MethodsArticles published between January 2005 and October 2015 that studied prevalence or influencing factors of MRSA nasal colonization in Chinese children were retrieved from Chinese Biomedical Literature database (CBM), China National Knowledge Infrastructure (CNKI) database, Chinese VIP database, Chinese Wanfang database, Medline database and Ovid database. Prevalence and influencing factors were analyzed by STATA 13.1.ResultsThirteen articles were included. The overall prevalence of MRSA nasal colonization was 4.4% (95% confidence interval [CI]: 0.027–0.062). With an MRSA prevalence of 3.9% (95% CI: 0.018–0.061) in healthy children and 5.8% (95% CI: 0.025–0.092) in children with underlying medical conditions. Children recruited in the hospitals presented MRSA prevalence of 6.4% (95% CI: 0.037–0.091), which was higher than those recruited in the communities [2.7% (95% CI: 0.012–0.043)]. A number of influencing factors for MRSA nasal colonization were noted in three eligible studies: gender (male vs female; OR: 0.67; 95% CI: 0.55–0.82), younger age (OR: 2.98; 95% CI: 1.31–6.96 and OR: 1.56; 95% CI: 1.21–2.00), attending day care centers (OR: 2.97; 95% CI: 1.28–6.76), having infectious diseases (OR: 2.31; 95% CI: 1.10–4.52), using antibiotics (OR: 2.77; 95% CI: 1.45–5.05), residing in northern Taiwan (OR: 1.41; 95% CI: 1.15–1.71), passive smoking (OR: 1.30; 95% CI: 1.02–1.63), and pneumococcal vaccination (OR: 1.22; 95% CI: 1.01–1.48).ConclusionsChildren could act as reservoirs of MRSA transmissions. Hospitals remained the most frequent microorganism-circulated settings. More MRSA infection control strategies are required to prevent the dissemination among children.

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Section: Discussioncontrasting

confidence: 60%

Methicillin-Resistant Staphylococcus aureus Nasal Colonization in Chinese Children: A Prevalence Meta-Analysis and Review of Influencing Factors

Lin

Yang

et al. 2016

PLoS ONE

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“…Similarly, studies from other countries reported CC9 (ST9 and single-locus variants) as the predominant S. aureus and MRSA genotype in pigs and related workers in Asia, indicating the potential for transmission of S. aureus (including MRSA) between livestock and humans (3,18). Our recent study also revealed that there are significant frequency-risk and shortterm duration-risk relationships between occupational pig contact and MRSA carriage, suggesting the probability of LA-MRSA spread via animal contact, a scenario demonstrated for LA-MRSA transmission in Europe and Asia (10). Rather than CC9, CC398 is the most prevalent LA-MRSA genotype associated with various animals and humans across European countries and North America (19,20).…”

Section: Discussionmentioning

confidence: 88%

Genotypic and Phenotypic Markers of Livestock-Associated Methicillin-Resistant Staphylococcus aureus CC9 in Humans

Wang

Fan

et al. 2016

Appl Environ Microbiol

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Use of antimicrobials in industrial food animal production is associated with the presence of multidrug-resistant Staphylococcus aureus among animals and humans. The livestock-associated (LA) methicillin-resistant S. aureus (MRSA) clonal complex 9 (CC9) is associated with animals and related workers in Asia. This study aimed to explore the genotypic and phenotypic markers of LA-MRSA CC9 in humans. We conducted a cross-sectional study of livestock workers and controls in Guangdong, China. The study participants responded to a questionnaire and provided a nasal swab for S. aureus analysis. The resulting isolates were assessed for antibiotic susceptibility, multilocus sequence type, and immune evasion cluster (IEC) genes. Methicillin-resistant Staphylococcus aureus (MRSA) is one of the leading causes of antibiotic-resistant nosocomial infections, causing diseases ranging from minor skin infections to severe septicemia and pneumonia, and is of particular concern because few antibiotics are effective at treating infections caused by the pathogen. The epidemiology of MRSA has changed with the increasing emergence of community-associated MRSA (1, 2). Recently, another MRSA clone emerged in the community, which was observed in livestock and related workers and was referred to as livestock-associated MRSA (LA-MRSA) (3). Livestock, especially pigs, can serve as reservoirs for LA-MRSA, and the bacteria can also be transmitted to humans in close contact with MRSAcolonized animals (4, 5).LA-MRSA isolates have unique molecular characteristics that distinguish them from community-associated MRSA and health care-associated MRSA, and these characteristics vary according to the geographic area. Sequence type 398 (ST398) has been referred to as the most pandemic LA-MRSA in Europe and North America, while ST9 is the most prevalent LA-MRSA in most Asian countries (3). However, persons living in areas of high livestock density were also found to have a greater risk of LA-MRSA carriage even if they lacked direct contact with livestock (6, 7). Thus, the possibility of direct and indirect livestock contact as a potential source of human MRSA infection has become a growing public health concern.Few reports have described the epidemiology and molecular characteristics of LA-MRSA in developing countries in Asia. In China, MRSA has been isolated from pigs and pig workers (8, 9). However, there is still very limited information on LA-MRSA infection among healthy people. In addition, few studies examining human MRSA carriage have attempted to differentiate humanfrom livestock-associated isolates based on genotypic and phenotypic markers. The goals of this study, therefore, were to determine the prevalence of MRSA (including LA-MRSA) in livestock workers and control workers in Guangdong, as well as to use the multifactor dimensionality reduction method to detect the genotypic and phenotypic markers for LA-MRSA. MATERIALS AND METHODSEthics statement. This study was approved by the Ethics Committee of Guangdong Pharmaceutical Universit...

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“…CC59 is widespread in humans and several MRSA strains originate from this lineage [109,138,139,140]. It has been detected in workers in contact with livestock or animal carcasses [141,142] and retail food [143] as well as in pets [144] but we are not aware of reports to date from wildlife.…”

Section: Resultsmentioning

confidence: 99%

Diversity of Staphylococcus aureus Isolates in European Wildlife

et al. 2016

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Staphylococcus aureus is a well-known colonizer and cause of infection among animals and it has been described from numerous domestic and wild animal species. The aim of the present study was to investigate the molecular epidemiology of S. aureus in a convenience sample of European wildlife and to review what previously has been observed in the subject field. 124 S. aureus isolates were collected from wildlife in Germany, Austria and Sweden; they were characterized by DNA microarray hybridization and, for isolates with novel hybridization patterns, by multilocus sequence typing (MLST). The isolates were assigned to 29 clonal complexes and singleton sequence types (CC1, CC5, CC6, CC7, CC8, CC9, CC12, CC15, CC22, CC25, CC30, CC49, CC59, CC88, CC97, CC130, CC133, CC398, ST425, CC599, CC692, CC707, ST890, CC1956, ST2425, CC2671, ST2691, CC2767 and ST2963), some of which (ST2425, ST2691, ST2963) were not described previously. Resistance rates in wildlife strains were rather low and mecA-MRSA isolates were rare (n = 6). mecC-MRSA (n = 8) were identified from a fox, a fallow deer, hares and hedgehogs. The common cattle-associated lineages CC479 and CC705 were not detected in wildlife in the present study while, in contrast, a third common cattle lineage, CC97, was found to be common among cervids. No Staphylococcus argenteus or Staphylococcus schweitzeri-like isolates were found. Systematic studies are required to monitor the possible transmission of human- and livestock-associated S. aureus/MRSA to wildlife and vice versa as well as the possible transmission, by unprotected contact to animals. The prevalence of S. aureus/MRSA in wildlife as well as its population structures in different wildlife host species warrants further investigation.

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Frequency-risk and duration-risk relations between occupational livestock contact and methicillin-resistant Staphylococcus aureus carriage among workers in Guangdong, China

Cited by 19 publications

References 30 publications

Methicillin-Resistant Staphylococcus aureus Nasal Colonization in Chinese Children: A Prevalence Meta-Analysis and Review of Influencing Factors

Methicillin-Resistant Staphylococcus aureus Nasal Colonization in Chinese Children: A Prevalence Meta-Analysis and Review of Influencing Factors

Genotypic and Phenotypic Markers of Livestock-Associated Methicillin-Resistant Staphylococcus aureus CC9 in Humans

Diversity of Staphylococcus aureus Isolates in European Wildlife

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