title: Dose-response relationship between antimicrobial drugs and livestock-associated MRSA in pig farming.
abstract: The farming community can be a vehicle for introduction of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) in hospitals. During 2011-2013, an 18-month longitudinal study aimed at reducing the prevalence of LA-MRSA was conducted on 36 pig farms in the Netherlands. Evaluations every 6 months showed a slight decrease in MRSA prevalence in animals and a stable prevalence in farmers and family members. Antimicrobial use, expressed as defined daily dosages per animal per year, decreased 44% during the study period and was associated with declining MRSA prevalence in pigs. MRSA carriage in animals was substantially higher at farms using cephalosporins. Antimicrobial use remained strongly associated with LA-MRSA in humans regardless of the level of animal contact. A risk factor analysis outlined potential future interventions for LA-MRSA control. These results should encourage animal and public health authorities to maintain their efforts in reducing antimicrobial use in livestock and ask for future controlled intervention studies.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Dorado-García
authors.forename: Wietske
authors.initials: W
authors.lastname: Dohmen
authors.forename: Marian E H
authors.initials: ME
authors.lastname: Bos
authors.forename: Koen M
authors.initials: KM
authors.lastname: Verstappen
authors.forename: Manon
authors.initials: M
authors.lastname: Houben
authors.forename: Jaap A
authors.initials: JA
authors.lastname: Wagenaar
authors.forename: Dick J J
authors.initials: DJ
authors.lastname: Heederik
mesh_terms: D000383:Agriculture; D000820:Animal Diseases / Q000453:epidemiology* / Q000382:microbiology*; D000818:Animals; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D058751:Livestock / Q000382:microbiology*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification / Q000187:drug effects*; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000662:veterinary*; D013552:Swine
chemical_list: D000890:Anti-Infective Agents
keywords: MRSA; antibacterial drug resistance; antimicrobial resistance; bacteria; methicillin-resistant Staphylococcus aureus; pigs; risk reduction; zoonoses