title: MRSA CC398 in the pig production chain.
abstract: In 2005, a distinct clone of methicillin resistant Staphylococcus aureus (MRSA CC398) was found in pigs and people in contact with pigs. The structure of the pig production chain in high technology pig husbandry enables pathogens to spread during animal trading, with an increasing prevalence in herds further down the chain. The objective of this study was to quantify the effect of the MRSA status of the supplying herd on the MRSA status of the receiving herd in order to gain more insight into the role of animal trading as a transmission route for MRSA CC398. Nasal samples (60-80 pigs per herd) were collected from 38 herds; in 20 herds, environmental samples were collected as well. Ten MRSA-positive herds (based on the results of nasal swabs of 10 individual pigs per herd) from a prior study were included in the data analysis. Herds were classified as MRSA positive if at least one sample tested positive. The 48 herds were part of 14 complete (40 herds) and 4 incomplete (8 herds) pig production chains. Fifty-six percent of the herds were classified as MRSA positive. MRSA-positive herds were observed at the start (breeding herds), middle (farrowing herds) and the end (finishing herds) of the pig production chain. All of the herds in 8 chains tested MRSA positive;, all of the herds in 5 chains tested MRSA negative and in the remaining 5 chains, MRSA-positive and MRSA-negative herds were detected. Seven spa types were found, which were all previously confirmed to belong to CC398. All of the isolates were susceptible to mupirocin, linezolid, rifampicin, fusidic acid and cotrimoxazole. Resistance against tetracycline, erythromycin and clindamycin was found in 100, 74 and 76% of the isolates, respectively. Seventy-nine percent of herds with a MRSA-positive supplier of pigs were MRSA positive, whereas 23% of herds with a MRSA-negative supplier were MRSA positive (OR=10.8; 95% CI: 1.5-110.1; P=0.011). The presence of entirely MRSA-positive and MRSA-negative chains and the strong association between the MRSA status of herds and their suppliers illustrates a large risk associated with purchasing pigs from MRSA-positive herds; a top-down strategy for future control programs is, therefore, a basic requirement. However, 23% of herds with a MRSA-negative supplier were MRSA positive and furthermore, 46% of the herds at the top of the pig production chain without a supplier tested MRSA positive. This underlined the need for the identification of additional risk factors for MRSA.
authors.affiliation: Quantitative Veterinary Epidemiology Group, Wageningen Institute of Animal Sciences, Wageningen University, P.O. Box 338, 6700 AH Wageningen, The Netherlands. els.broens@wur.nl
authors.forename: E M
authors.initials: EM
authors.lastname: Broens
authors.forename: E A M
authors.initials: EA
authors.lastname: Graat
authors.forename: P J
authors.initials: PJ
authors.lastname: van der Wolf
authors.forename: A W
authors.initials: AW
authors.lastname: van de Giessen
authors.forename: E
authors.initials: E
authors.lastname: van Duijkeren
authors.forename: J A
authors.initials: JA
authors.lastname: Wagenaar
authors.forename: A
authors.initials: A
authors.lastname: van Nes
authors.forename: D J
authors.initials: DJ
authors.lastname: Mevius
authors.forename: M C M
authors.initials: MC
authors.lastname: de Jong
mesh_terms: D000822:Animal Husbandry / Q000379:methods*; D000818:Animals; D004783:Environmental Microbiology; D005260:Female; D005506:Food Contamination / Q000517:prevention & control; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D009296:Nasal Cavity / Q000382:microbiology; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission* / Q000662:veterinary*; D013552:Swine; D013553:Swine Diseases / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D015047:Zoonoses