title: MRSA in persons not living or working on a farm in a livestock-dense area: prevalence and risk factors.
abstract: MRSA emerged in livestock and persons in contact with livestock is referred to as livestock-associated MRSA (LA-MRSA). We assessed the prevalence and risk factors for MRSA carriage in persons not living or working on a farm.
  
  
  
  A cross-sectional study was performed among 2492 adults living in close proximity of livestock farms. Persons working and/or living on farms were excluded. Nasal swabs were cultured using selective media. Participants completed questionnaires and the distance from the residential address to the nearest farm was calculated. The Mann-Whitney U -test was used to compare median distances. Risk factors were explored with logistic regression.
  
  
  
  Fourteen persons carried MRSA (0.56%; 95% CI 0.32%-0.92%), 10 of which carried LA-MRSA of multiple-locus variable-number tandem repeat analysis complex (MC) 398 (0.40%; 95% CI 0.20%-0.71%). MRSA MC 398 carriers lived significantly closer to the nearest farm than non-carriers (median: 184 versus 402 m; P  <   0.01). In bivariate analyses correcting for contact with livestock, this difference remained significant.
  
  
  
  Although the prevalence was low, living near farms increased the risk of MRSA MC 398 carriage for persons not living or working on a farm. Further research is necessary to identify the transmission routes.
authors.affiliation: Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, BA 3720, The Netherlands.
authors.forename: Tizza P
authors.initials: TP
authors.lastname: Zomer
authors.affiliation: Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, BA 3720, The Netherlands.
authors.forename: Cornelia C H
authors.initials: CC
authors.lastname: Wielders
authors.affiliation: Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, BA 3720, The Netherlands.
authors.forename: Christiaan
authors.initials: C
authors.lastname: Veenman
authors.affiliation: Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, BA 3720, The Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Hengeveld
authors.affiliation: Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, BA 3720, The Netherlands.
authors.forename: Wim
authors.initials: W
authors.lastname: van der Hoek
authors.affiliation: Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, BA 3720, The Netherlands.
authors.forename: Sabine C
authors.initials: SC
authors.lastname: de Greeff
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, TD 3508, The Netherlands.
authors.forename: Lidwien A M
authors.initials: LA
authors.lastname: Smit
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, TD 3508, The Netherlands.
authors.forename: Dick J
authors.initials: DJ
authors.lastname: Heederik
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, BN 3500, The Netherlands.
authors.forename: C Joris
authors.initials: CJ
authors.lastname: Yzermans
authors.affiliation: Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, BA 3720, The Netherlands.
authors.forename: Thijs
authors.initials: T
authors.lastname: Bosch
authors.affiliation: Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, BA 3720, The Netherlands.
authors.forename: Catharina B M
authors.initials: CB
authors.lastname: Maassen
authors.affiliation: Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, BA 3720, The Netherlands.
authors.forename: Engeline
authors.initials: E
authors.lastname: van Duijkeren
mesh_terms: D000328:Adult; D000383:Agriculture; D000818:Animals; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D003430:Cross-Sectional Studies; D000072480:Farms; D005260:Female; D006801:Humans; D058751:Livestock / Q000382:microbiology; D016015:Logistic Models; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D009666:Nose / Q000382:microbiology; D015995:Prevalence; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000635:transmission; D011795:Surveys and Questionnaires