title: Impact of livestock-associated MRSA in a hospital setting.
abstract: OBJECTIVE
  The Netherlands is known for a stringent search and destroy policy to prevent spread of MRSA. In the hospital setting, livestock-associated MRSA (LA-MRSA) is frequently found in patients coming from the high density farming area in the south of the Netherlands. The aim of the study was to determine the contribution of LA-MRSA in the epidemiology of MRSA in cases found following the Dutch search and destroy policy.
  
  
  METHODS
  From two hospitals serving a population of 550,000 persons all data on MRSA cultures and subsequent control measures from 2008 and 2009 were retrospectively collected and analyzed.
  
  
  RESULTS
  A total of 3856 potential index patients were screened for MRSA, 373 (9.7%) were found to be positive, 292 ( 78%) LA-MRSA and 81 (22%) non-LA-MRSA respectively. No secondary cases were found among contact research in persons exposed to LA-MRSA (0/416), whereas similar contact research for non-LA-MRSA resulted in 83 (2.5%) secondary cases. LA-MRSA were rarely found to cause infections.
  
  
  CONCLUSIONS
  LA-MRSA is more prevalent than non-LA-MRSA in Dutch Hospitals in the South of the Netherlands. However, retrospectively studied cases show that the transmission rate for LA-MRSA was much lower than for non-LA-MRSA. This suggest that infection control practices for LA-MRSA may possibly be less stringent than for non-LA-MRSA.
authors.affiliation: Center for Infectious Disease Control, Epidemiology and Surveillance, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
authors.forename: Nienke
authors.initials: N
authors.lastname: van de Sande-Bruinsma
authors.affiliation: Center for Infectious Disease Control, Epidemiology and Surveillance, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands ; Department of Medical Microbiology and Infection Control, Bronovo Hospital, The Hague, The Netherlands.
authors.forename: Maurine A
authors.initials: MA
authors.lastname: Leverstein van Hall
authors.affiliation: Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, PO Box 90153, 's-Hertogenbosch, 5200 ME The Netherlands.
authors.forename: Maria
authors.initials: M
authors.lastname: Janssen
authors.affiliation: Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, PO Box 90153, 's-Hertogenbosch, 5200 ME The Netherlands.
authors.forename: Nynke
authors.initials: N
authors.lastname: Nagtzaam
authors.affiliation: Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, PO Box 90153, 's-Hertogenbosch, 5200 ME The Netherlands.
authors.forename: Sander
authors.initials: S
authors.lastname: Leenders
authors.affiliation: Center for Infectious Disease Control, Epidemiology and Surveillance, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
authors.forename: Sabine C
authors.initials: SC
authors.lastname: de Greeff
authors.affiliation: Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, PO Box 90153, 's-Hertogenbosch, 5200 ME The Netherlands.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Schneeberger
keywords: Carriage; Infection control; MRSA