title: Persistence of livestock-associated antibiotic-resistant Staphylococcus aureus among industrial hog operation workers in North Carolina over 14 days.
abstract: OBJECTIVE
  This study aimed to evaluate the persistence of nasal carriage of Staphylococcus aureus, methicillin-resistant S. aureus and multidrug-resistant S. aureus over 14 days of follow-up among industrial hog operation workers in North Carolina.
  
  
  METHODS
  Workers anticipating at least 24 h away from work were enrolled June-August 2012. Participants self-collected a nasal swab and completed a study journal on the evening of day 1, and each morning and evening on days 2-7 and 14 of the study. S. aureus isolated from nasal swabs were assessed for antibiotic susceptibility, spa type and absence of the scn gene. Livestock association was defined by absence of scn.
  
  
  RESULTS
  Twenty-two workers provided 327 samples. S. aureus carriage end points did not change with time away from work (mean 49 h; range >0-96 h). Ten workers were persistent and six were intermittent carriers of livestock-associated S. aureus. Six workers were persistent and three intermittent carriers of livestock-associated multidrug-resistant S. aureus. One worker persistently carried livestock-associated methicillin-resistant S. aureus. Six workers were non-carriers of livestock-associated S. aureus. Eighty-two per cent of livestock-associated S. aureus demonstrated resistance to tetracycline. A majority of livestock-associated S. aureus isolates (n=169) were CC398 (68%) while 31% were CC9. No CC398 and one CC9 isolate was detected among scn-positive isolates.
  
  
  CONCLUSIONS
  Nasal carriage of livestock-associated S. aureus, multidrug-resistant S. aureus and methicillin-resistant S. aureus can persist among industrial hog operation workers over a 14-day period, which included up to 96 h away from work.
authors.affiliation: Department of Environmental Sciences & Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Maya
authors.initials: M
authors.lastname: Nadimpalli
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Rinsky
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Steve
authors.initials: S
authors.lastname: Wing
authors.affiliation: Rural Empowerment Association for Community Help (REACH), Warsaw, North Carolina, USA.
authors.forename: Devon
authors.initials: D
authors.lastname: Hall
authors.affiliation: Department of Environmental Sciences & Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Jill
authors.initials: J
authors.lastname: Stewart
authors.affiliation: Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark.
authors.forename: Jesper
authors.initials: J
authors.lastname: Larsen
authors.affiliation: Johns Hopkins Center for a Livable Future, Johns Hopkins University, Baltimore Maryland, USA Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Keeve E
authors.initials: KE
authors.lastname: Nachman
authors.affiliation: Johns Hopkins Center for a Livable Future, Johns Hopkins University, Baltimore Maryland, USA Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Dave C
authors.initials: DC
authors.lastname: Love
authors.affiliation: Department of Environmental Sciences & Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Pierce
authors.affiliation: Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Nora
authors.initials: N
authors.lastname: Pisanic
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Jean
authors.initials: J
authors.lastname: Strelitz
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Laurel
authors.initials: L
authors.lastname: Harduar-Morano
authors.affiliation: Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Heaney
mesh_terms: D000328:Adult; D000822:Animal Husbandry; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002353:Carrier State; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005798:Genes, Bacterial; D006801:Humans; D058751:Livestock / Q000382:microbiology*; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D008875:Middle Aged; D009657:North Carolina; D009666:Nose / Q000382:microbiology; D009784:Occupational Diseases / Q000382:microbiology; D016273:Occupational Exposure; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D013552:Swine / Q000382:microbiology*; D013752:Tetracycline / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D013752:Tetracycline