title: Livestock density as risk factor for livestock-associated methicillin-resistant Staphylococcus aureus, the Netherlands.
abstract: To determine whether persons living in areas of high animal density are at increased risk for carrying livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA), we used an existing dataset of persons in the Netherlands with LA-MRSA carriage and controls who carried other types of MRSA. Results of running univariate and multivariate logistic regression models indicated that living in livestock-dense areas increases the odds of nasal carriage of LA-MRSA. We found that doubling pig, cattle, and veal calf densities per municipality increased the odds of LA-MRSA carriage over carriage of other types of MRSA by 24.7% (95% CI 0.9%-54.2%), 76.9% (95% CI 11.3%-81.3%), and 24.1% (95% CI 5.5%-45.9%), respectively, after adjusting for direct animal contact, living in a rural area, and the probable source of MRSA carriage. Controlling the spread of LA-MRSA thus requires giving attention to community members in animal-dense regions who are unaffiliated with livestock farming.
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21218, USA. beth.feingold@jhu.edu
authors.forename: Beth J
authors.initials: BJ
authors.lastname: Feingold
authors.forename: Ellen K
authors.initials: EK
authors.lastname: Silbergeld
authors.forename: Frank C
authors.initials: FC
authors.lastname: Curriero
authors.forename: Brigite A G L
authors.initials: BA
authors.lastname: van Cleef
authors.forename: Max E O C
authors.initials: ME
authors.lastname: Heck
authors.forename: Jan A J W
authors.initials: JA
authors.lastname: Kluytmans
mesh_terms: D000818:Animals; D002353:Carrier State / Q000453:epidemiology; D016022:Case-Control Studies; D016000:Cluster Analysis; D006801:Humans; D058751:Livestock / Q000382:microbiology*; D016015:Logistic Models; D055624:Methicillin-Resistant Staphylococcus aureus; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D011156:Population Density; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology*