title: The Prevalence of Antibiotic-ResistantStaphylococcus aureusNasal Carriage among Industrial Hog Operation Workers, Community Residents, and Children Living in Their Households: North Carolina, USA.
abstract: Antibiotic use in industrial hog operations (IHOs) can support the emergence of antibiotic-resistant (ABR)Staphylococcus aureus. The extent of ABRS. aureusexposure in IHO workers and children living in their households remains unclear.
  
  
  
  We investigated ABRS. aureusnasal carriage prevalence among adults with versus without occupational exposure to IHOs and among children living in their households.
  
  
  
  In total, 198 IHO worker-child household pairs and 202 community referent (CR) adult-child household pairs completed a questionnaire and provided a nasal swab which was analyzed forS. aureus,methicillin-resistantS. aureus(MRSA), multidrug-resistantS. aureus(MDRSA), absence ofscn(putative marker of livestock association), andspatype.
  
  
  
  S. aureusnasal carriage prevalence was higher among IHO (53%) compared with CR (31%) adults [adjusted prevalence ratio (aPR): 1.40; 95% confidence interval (CI): 1.07, 1.83], but MRSA nasal carriage prevalence was uncommon (2-3%) in IHO and CR adults. MDRSA nasal carriage prevalence was similar among IHO workers and CR adults (12% vs. 8%; aPR: 1.14; 95% CI: 0.56, 2.29). Nasal carriage prevalence was higher among IHO compared with CR children forS. aureus(49% vs. 31%; aPR: 1.50; 95% CI: 1.13, 1.99), MRSA (14% vs. 6%; aPR: 2.37; 95% CI: 1.14, 4.92), and MDRSA (23% vs. 8%; aPR: 2.64; 95% CI: 1.47, 4.75). We also found suggestive evidence of a higher prevalence ofS. aureus, MRSA, and MDRSA among children living with an IHO worker who did versus did not report taking personal protective equipment (PPE) home from the IHO. Livestock-associatedS. aureusnasal carriage predominated among IHO workers.
  
  
  
  Our findings support the importance of further research on the prevalence and potential sources of exposure to ABRS. aureusamong children living with IHO workers.
authors.affiliation: Department of Environmental Sciences and Engineering, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Hatcher
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Rhodes
authors.forename: Jill R
authors.initials: JR
authors.lastname: Stewart
authors.forename: Ellen
authors.initials: E
authors.lastname: Silbergeld
authors.forename: Nora
authors.initials: N
authors.lastname: Pisanic
authors.forename: Jesper
authors.initials: J
authors.lastname: Larsen
authors.forename: Sharon
authors.initials: S
authors.lastname: Jiang
authors.forename: Amanda
authors.initials: A
authors.lastname: Krosche
authors.forename: Devon
authors.initials: D
authors.lastname: Hall
authors.forename: Karen C
authors.initials: KC
authors.lastname: Carroll
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Heaney
mesh_terms: D000328:Adult; D000822:Animal Husbandry / Q000706:statistics & numerical data*; D002648:Child; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics*; D009657:North Carolina / Q000453:epidemiology; D016273:Occupational Exposure / Q000706:statistics & numerical data; D015995:Prevalence; D013203:Staphylococcal Infections