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Pig Farmers at High Risk for Methicillin-resistant Staphylococcus Aureus Infection: Presented at ECCMID

By Chris Berrie

NICE, FRANCE -- April 4, 2006 -- The previously unsuspected clonal spread and transmission of methicillin-resistant Staphylococcus aureus (MRSA) between man and pigs in the Netherlands demonstrates the need for the addition to the Netherlands "Search and Destroy" strategy for MRSA of pig farmers and their pigs, as a new group that can be considered as high risk for MRSA, according to a study presented here at the 16^th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID).

The incidence of MRSA in the Netherlands is one of the lowest around the world due to the introduction of the "Search and Destroy" policy for MRSA in 1986. However, more recently, an increasing number of cases that have not followed the classical risk factors for MRSA colonisation have been seen, researchers said in a presentation on April 2^nd.

One of these cases provided the basis for a study into the source of MRSA in the family of a pig farmer that had no known risk factors for MRSA carriership, but whose family members were found to be permanent MRSA carriers.

Principal investigator Andreas Voss, MD, PhD, head, Infection Control, Canisius-Wilhelmina Hospital, and professor of Infection Control, Radboud University Medical Centre, Nijmegen, The Netherlands, presented the study's findings.

"This is a phenomenon that you can only recognise in a country with a low prevalence of MRSA, where every single unexpected case is followed up, in order to know where it is coming from," Dr. Voss explained

This initial case arose in October 2004, with a young mother with mastitis who was suffering from high fevers (>39 °C), general malaise and pleural effusions. After cultures taken by her physician unexpectedly revealed MRSA, she was treated with teicoplanin and showed a quick recovery.

However, when she remained an MRSA carrier, further tests revealed her husband, baby and 3 of their farm workers also were MRSA carriers. As animals have also been described as potential sources of MRSA, the tests were extended to the pigs on the farm.

Ten of the 8000 pigs were picked at random and cultures were taken from their anterior nares, throat and perineum. All of the cultures were processed in the laboratory following national guidelines for the detection of MRSA in human samples.

Although the MRSA isolates from the positive tests from both the family and the pigs were untypable using pulse-field gel electrophoresis (PFGE), they were seen to be identical on spa-typing (t108) and multilocus sequence typing (MLST) analysis (MS398).

More recently, as Dr Voss indicated, "We have looked further at the farmers, and not only more than 20% of the pig farmers, but also 39% of the pigs in our region were MRSA carriers, along with 4.8% of the Dutch veterinarians."

"What we have here is something that is clearly lacking, and should be included in the Search and Destroy policy in the Netherlands," stressed Dr Voss. He also noted that this is a European phenomenon, and not just a Dutch phenomenon, with the correlation of antibiotic use with farming and the known presence of MRSA in horses and other animals.


[Study title: Community-acquired MRSA and Pig Farming. Abstract P474]

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