title: Methicillin-Resistant Staphylococcus aureus spa Type t002 Outbreak in Horses and Staff at a Veterinary Teaching Hospital after Its Presumed Introduction by a Veterinarian.
abstract: Methicillin-resistant Staphylococcus aureus (MRSA) infection and colonization, involving MRSA strains which differ from common human health care-associated clones, have become serious emerging conditions in equine veterinary hospitals. In 2010, MRSA spa type t535 caused an outbreak involving both horses and personnel in a veterinary teaching hospital in Israel. Since then, surveillance continued, and occasional MRSA isolation occurred. Two years later, MRSA of another spa type, t002, was isolated from a veterinarian and, 3 weeks later, from a horse. The appearance of spa type t002, a common clone in human medicine in Israel, among both personnel and horses, prompted a point-prevalence survey of hospital personnel and hospitalized horses. Fifty-nine staff members (n = 16 equine; n = 43, other) and 14 horses were screened. Ten of 59 staff members (16.9%) and 7 of 14 horses (50%) were MRSA carriers. Among the staff, 44% of large animal department (LAD) personnel, compared with only 7% of non-LAD personnel, were carriers. Isolates from all horses and from 9 of 10 personnel were found to be of MRSA spa type t002. This clone was later isolated from an infected postoperative wound in a hospitalized horse. Measures were taken to contain transmission between horses and personnel, as was done in the previous outbreak, resulting in reduction of transmission and, finally, cessation of cross-transmission between horses and personnel.
authors.affiliation: Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food, and Environment, The Hebrew University of Jerusalem, Rehovot, Israel amirst@savion.huji.ac.il.
authors.forename: Amir
authors.initials: A
authors.lastname: Steinman
authors.affiliation: National Center for Infection Control, Israel Ministry of Health, Tel Aviv, Israel.
authors.forename: Samira
authors.initials: S
authors.lastname: Masarwa
authors.affiliation: Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food, and Environment, The Hebrew University of Jerusalem, Rehovot, Israel.
authors.forename: Sharon
authors.initials: S
authors.lastname: Tirosh-Levy
authors.affiliation: Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food, and Environment, The Hebrew University of Jerusalem, Rehovot, Israel.
authors.forename: Dan
authors.initials: D
authors.lastname: Gleser
authors.affiliation: Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food, and Environment, The Hebrew University of Jerusalem, Rehovot, Israel.
authors.forename: Gal
authors.initials: G
authors.lastname: Kelmer
authors.affiliation: National Center for Infection Control, Israel Ministry of Health, Tel Aviv, Israel.
authors.forename: Amos
authors.initials: A
authors.lastname: Adler
authors.affiliation: National Center for Infection Control, Israel Ministry of Health, Tel Aviv, Israel.
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Carmeli
authors.affiliation: National Center for Infection Control, Israel Ministry of Health, Tel Aviv, Israel.
authors.forename: Mitchell J
authors.initials: MJ
authors.lastname: Schwaber
mesh_terms: D000818:Animals; D002353:Carrier State / Q000453:epidemiology / Q000635:transmission / Q000662:veterinary; D004196:Disease Outbreaks; D018562:Disease Transmission, Infectious; D005838:Genotype; D006282:Health Personnel; D006734:Horse Diseases / Q000453:epidemiology* / Q000635:transmission; D006736:Horses; D006762:Hospitals, Animal; D006784:Hospitals, Teaching; D006801:Humans; D007557:Israel / Q000453:epidemiology; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D017720:Molecular Epidemiology; D058889:Molecular Typing; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000635:transmission / Q000662:veterinary*; D013205:Staphylococcal Protein A / Q000235:genetics; D018634:Veterinarians
chemical_list: D013205:Staphylococcal Protein A