title: Detection of livestock-associated methicillin-resistant Staphylococcus aureus among swine workers in Romania.
abstract: BACKGROUND
  Methicillin-resistant Staphylococcus aureus (MRSA) is a devastating pathogen that is associated with high morbidity and mortality worldwide. Livestock are a well-known reservoir for this pathogen, which poses substantial health risks for livestock workers. Little is known about the epidemiology of livestock-associated MRSA (LA-MRSA) among livestock workers in Eastern Europe.
  
  
  METHODS
  To study the epidemiology of LA-MRSA among swine workers in Romania, we collected and characterized nasal and oropharygneal samples from swine workers on commercial pig farms. A survey that included questions about work-related tasks, biosafety practices, contact with animals, and health status was used to assess the risk factors that were potentially associated with LA-MRSA colonization.
  
  
  RESULTS
  The prevalence of MRSA colonization among swine workers was 6.8%. Two LA-MRSA strains with the spa types t034 and t011 and one likely community-associated MRSA strain with the spa type t321 were isolated from workers on five farms. Interestingly, all MRSA carriers worked on farms that imported animals from other production facilities.
  
  
  CONCLUSIONS
  This is the first study to confirm the presence of LA-MRSA among swine workers in Romania and suggests the need to minimize the risk of LA-MRSA-related infections in swine workers and their community contacts. The findings also suggest a link between the commercial movement of swine and the introduction of LA-MRSA.
authors.affiliation: Yale School of Public Health, Yale University, New Haven, CT, United States. Electronic address: Eileen.Huang11@gmail.com.
authors.forename: Eileen
authors.initials: E
authors.lastname: Huang
authors.affiliation: Environmental Health Center, Busuiocului 58, 400240 Cluj-Napoca, Romania.
authors.forename: Anca E
authors.initials: AE
authors.lastname: Gurzau
authors.affiliation: College of Public Health, University of Iowa, Iowa City, IA, United States.
authors.forename: Blake M
authors.initials: BM
authors.lastname: Hanson
authors.affiliation: College of Public Health, University of Iowa, Iowa City, IA, United States.
authors.forename: Ashley E
authors.initials: AE
authors.lastname: Kates
authors.affiliation: College of Public Health, University of Iowa, Iowa City, IA, United States.
authors.forename: Tara C
authors.initials: TC
authors.lastname: Smith
authors.affiliation: Yale School of Public Health, Yale University, New Haven, CT, United States.
authors.forename: Melinda M
authors.initials: MM
authors.lastname: Pettigrew
authors.affiliation: Faculty of Veterinary Medicine, University of Agricultural Science and Veterinary Medicine, Cluj-Napoca, Romania.
authors.forename: Marina
authors.initials: M
authors.lastname: Spinu
authors.affiliation: University of Washington, Seattle, WA, United States.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Rabinowitz
mesh_terms: D000328:Adult; D000383:Agriculture; D000822:Animal Husbandry; D000818:Animals; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D058751:Livestock; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D008875:Middle Aged; D058889:Molecular Typing; D009297:Nasal Mucosa / Q000382:microbiology; D016273:Occupational Exposure; D009960:Oropharynx / Q000382:microbiology; D015995:Prevalence; D012383:Romania / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013205:Staphylococcal Protein A / Q000235:genetics; D011795:Surveys and Questionnaires; D013552:Swine
chemical_list: D013205:Staphylococcal Protein A
keywords: Antimicrobial resistance; Methicillin-resistant Staphylococcus aureus (MRSA); Occupational exposure; Swine; Zoonoses