title: Methicillin resistant Staphylococcus aureus ST398 in veal calf farming: human MRSA carriage related with animal antimicrobial usage and farm hygiene.
abstract: BACKGROUND
  Recently a specific MRSA sequence type, ST398, emerged in food production animals and farmers. Risk factors for carrying MRSA ST398 in both animals and humans have not been fully evaluated. In this cross-sectional study, we investigated factors associated with MRSA colonization in veal calves and humans working and living on these farms.
  
  
  METHODS
  A sample of 102 veal calf farms were randomly selected and visited from March 2007-February 2008. Participating farmers were asked to fill in a questionnaire (n = 390) to identify potential risk factors. A nasal swab was taken from each participant. Furthermore, nasal swabs were taken from calves (n = 2151). Swabs were analysed for MRSA by selective enrichment and suspected colonies were confirmed as MRSA by using slide coagulase test and PCR for presence of the mecA-gene. Spa types were identified and a random selection of each spa type was tested with ST398 specific PCR. The Sequence Type of non ST398 strains was determined. Data were analyzed using logistic regression analysis.
  
  
  RESULTS
  Human MRSA carriage was strongly associated with intensity of animal contact and with the number of MRSA positive animals on the farm. Calves were more often carrier when treated with antibiotics, while farm hygiene was associated with a lower prevalence of MRSA.
  
  
  CONCLUSIONS
  This is the first study showing direct associations between animal and human carriage of ST398. The direct associations between animal and human MRSA carriage and the association between MRSA and antimicrobial use in calves implicate prudent use of antibiotics in farm animals.
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands. h.graveland@uu.nl
authors.forename: Haitske
authors.initials: H
authors.lastname: Graveland
authors.forename: Jaap A
authors.initials: JA
authors.lastname: Wagenaar
authors.forename: Hans
authors.initials: H
authors.lastname: Heesterbeek
authors.forename: Dik
authors.initials: D
authors.lastname: Mevius
authors.forename: Engeline
authors.initials: E
authors.lastname: van Duijkeren
authors.forename: Dick
authors.initials: D
authors.lastname: Heederik
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000383:Agriculture; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002353:Carrier State; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006920:Hygiene; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult; D015047:Zoonoses
chemical_list: D000900:Anti-Bacterial Agents