Shylo E Wardyn1, Brett M Forshey1, Sarah A Farina2, Ashley E Kates1, Rajeshwari Nair1, Megan K Quick2, James Y Wu1, Blake M Hanson1, Sean M O'Malley2, Hannah W Shows2, Ellen M Heywood3, Laura E Beane-Freeman4, Charles F Lynch5, Margaret Carrel6, Tara C Smith7. 1. Center for Emerging Infectious Diseases Department of Epidemiology, College of Public Health. 2. Center for Emerging Infectious Diseases. 3. Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City. 4. Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland. 5. Department of Epidemiology, College of Public Health. 6. Department of Geographical and Sustainability Sciences, College of Liberal Arts and Sciences. 7. Department of Biostatistics, Environmental Health Sciences and Epidemiology, College of Public Health, Kent State University, Ohio.
Abstract
BACKGROUND: Livestock-associated Staphylococcus aureus (LA-SA) has been documented worldwide. However, much remains unknown about LA-SA colonization and infection, especially in rural environments. METHODS: We conducted a large-scale prospective study of 1342 Iowans, including individuals with livestock contact and a community-based comparison group. Nasal and throat swabs were collected to determine colonization at enrollment, and skin infection swabs over 17 months were assessed for S. aureus. Outcomes included carriage of S. aureus, methicillin-resistant S. aureus (MRSA), tetracycline-resistant S. aureus (TRSA), multidrug-resistant S. aureus (MDRSA), and LA-SA. RESULTS: Of 1342 participants, 351 (26.2%; 95% confidence interval [CI], 23.8%-28.6%) carried S. aureus. MRSA was isolated from 34 (2.5%; 95% CI, 1.8%-3.5%) and LA-SA from 131 (9.8%; 95% CI, 8.3%-11.5%) of the 1342 participants. Individuals with current swine exposure were significantly more likely to carry S. aureus (prevalence ratio [PR], 1.8; 95% CI, 1.4-2.2), TRSA (PR, 8.4; 95% CI, 5.6-12.6), MDRSA (PR, 6.1; 95% CI, 3.8-10.0), and LA-SA (PR, 5.8; 95% CI, 3.9-8.4) than those lacking exposure. Skin infections (n = 103) were reported from 67 individuals, yielding an incidence rate of 6.6 (95% CI, 4.9-8.9) per 1000 person-months. CONCLUSIONS: Current swine workers are 6 times more likely to carry MDRSA than those without current swine exposure. We observed active infections caused by LA-SA. This finding suggests that individuals with livestock contact may have a high prevalence of exposure to, and potentially infection with, antibiotic-resistant S. aureus strains, including LA-SA strains.
BACKGROUND: Livestock-associated Staphylococcus aureus (LA-SA) has been documented worldwide. However, much remains unknown about LA-SA colonization and infection, especially in rural environments. METHODS: We conducted a large-scale prospective study of 1342 Iowans, including individuals with livestock contact and a community-based comparison group. Nasal and throat swabs were collected to determine colonization at enrollment, and skin infection swabs over 17 months were assessed for S. aureus. Outcomes included carriage of S. aureus, methicillin-resistant S. aureus (MRSA), tetracycline-resistant S. aureus (TRSA), multidrug-resistant S. aureus (MDRSA), and LA-SA. RESULTS: Of 1342 participants, 351 (26.2%; 95% confidence interval [CI], 23.8%-28.6%) carried S. aureus. MRSA was isolated from 34 (2.5%; 95% CI, 1.8%-3.5%) and LA-SA from 131 (9.8%; 95% CI, 8.3%-11.5%) of the 1342 participants. Individuals with current swine exposure were significantly more likely to carry S. aureus (prevalence ratio [PR], 1.8; 95% CI, 1.4-2.2), TRSA (PR, 8.4; 95% CI, 5.6-12.6), MDRSA (PR, 6.1; 95% CI, 3.8-10.0), and LA-SA (PR, 5.8; 95% CI, 3.9-8.4) than those lacking exposure. Skin infections (n = 103) were reported from 67 individuals, yielding an incidence rate of 6.6 (95% CI, 4.9-8.9) per 1000 person-months. CONCLUSIONS: Current swine workers are 6 times more likely to carry MDRSA than those without current swine exposure. We observed active infections caused by LA-SA. This finding suggests that individuals with livestock contact may have a high prevalence of exposure to, and potentially infection with, antibiotic-resistant S. aureus strains, including LA-SA strains.
Authors: A-P Magiorakos; A Srinivasan; R B Carey; Y Carmeli; M E Falagas; C G Giske; S Harbarth; J F Hindler; G Kahlmeter; B Olsson-Liljequist; D L Paterson; L B Rice; J Stelling; M J Struelens; A Vatopoulos; J T Weber; D L Monnet Journal: Clin Microbiol Infect Date: 2011-07-27 Impact factor: 8.067
Authors: A E Dressler; R P Scheibel; S Wardyn; A L Harper; B M Hanson; J S Kroeger; D J Diekema; J B Bender; G C Gray; T C Smith Journal: Vet Rec Date: 2012-04-14 Impact factor: 2.695
Authors: Michael L Landrum; Charlotte Neumann; Courtney Cook; Uzo Chukwuma; Michael W Ellis; Duane R Hospenthal; Clinton K Murray Journal: JAMA Date: 2012-07-04 Impact factor: 56.272
Authors: Cristina Garcia-Graells; Brigitte A G L van Cleef; Jesper Larsen; Olivier Denis; Robert Skov; Andreas Voss Journal: PLoS One Date: 2013-05-31 Impact factor: 3.240
Authors: Lance B Price; Marc Stegger; Henrik Hasman; Maliha Aziz; Jesper Larsen; Paal Skytt Andersen; Talima Pearson; Andrew E Waters; Jeffrey T Foster; James Schupp; John Gillece; Elizabeth Driebe; Cindy M Liu; Burkhard Springer; Irena Zdovc; Antonio Battisti; Alessia Franco; Jacek Zmudzki; Stefan Schwarz; Patrick Butaye; Eric Jouy; Constanca Pomba; M Concepción Porrero; Raymond Ruimy; Tara C Smith; D Ashley Robinson; J Scott Weese; Carmen Sofia Arriola; Fangyou Yu; Frederic Laurent; Paul Keim; Robert Skov; Frank M Aarestrup Journal: MBio Date: 2012-02-21 Impact factor: 7.867
Authors: Jessica L Rinsky; Maya Nadimpalli; Steve Wing; Devon Hall; Dothula Baron; Lance B Price; Jesper Larsen; Marc Stegger; Jill Stewart; Christopher D Heaney Journal: PLoS One Date: 2013-07-02 Impact factor: 3.240
Authors: Alexander Mellmann; Thomas Weniger; Christoph Berssenbrügge; Jörg Rothgänger; Michael Sammeth; Jens Stoye; Dag Harmsen Journal: BMC Microbiol Date: 2007-10-29 Impact factor: 3.605
Authors: Meghan F Davis; Nora Pisanic; Sarah M Rhodes; Alexis Brown; Haley Keller; Maya Nadimpalli; Andrea Christ; Shanna Ludwig; Carly Ordak; Kristoffer Spicer; David C Love; Jesper Larsen; Asher Wright; Sarah Blacklin; Billy Flowers; Jill Stewart; Kenneth G Sexton; Ana M Rule; Christopher D Heaney Journal: Environ Res Date: 2018-02-22 Impact factor: 6.498
Authors: Abigail L Manson; Daria Van Tyne; Timothy J Straub; Sarah Clock; Michael Crupain; Urvashi Rangan; Michael S Gilmore; Ashlee M Earl Journal: Appl Environ Microbiol Date: 2019-10-30 Impact factor: 4.792
Authors: Isaac See; Paul Wesson; Nicole Gualandi; Ghinwa Dumyati; Lee H Harrison; Lindsey Lesher; Joelle Nadle; Susan Petit; Claire Reisenauer; William Schaffner; Amy Tunali; Yi Mu; Jennifer Ahern Journal: Clin Infect Dis Date: 2017-03-01 Impact factor: 9.079
Authors: Jonathan N Hofmann; Meredith S Shiels; Melissa C Friesen; Troy J Kemp; Anil K Chaturvedi; Charles F Lynch; Christine G Parks; Ligia A Pinto; Allan Hildesheim; Michael C R Alavanja; Laura E Beane Freeman Journal: Occup Environ Med Date: 2017-10-21 Impact factor: 4.402
Authors: Sarah Rhodes; Elizabeth Christenson; Allie Nguyen; Jesper Larsen; Lance B Price; Jill Stewart Journal: Environ Res Date: 2021-03-04 Impact factor: 6.498
Authors: Pranay R Randad; Jesper Larsen; Hülya Kaya; Nora Pisanic; Carly Ordak; Lance B Price; Maliha Aziz; Maya L Nadimpalli; Sarah Rhodes; Jill R Stewart; Dave C Love; David Mohr; Meghan F Davis; Lloyd S Miller; Devon Hall; Karen C Carroll; Trish M Perl; Christopher D Heaney Journal: Emerg Infect Dis Date: 2021-03 Impact factor: 6.883