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1.
Objective— To evaluate the prevalence of, and risk factors for, methicillin‐resistant Staphylococcus aureus (MRSA) colonization in veterinary personnel. Study Design— Cross‐sectional study. Sample Population— Conference attendees (n=341) at the 2008 American College of Veterinary Surgeons Symposium in San Diego California. Methods— Nasal swabs were collected and tested using selective culture for MRSA. Isolates were typed and risk factors were evaluated using questionnaire data. Results— 17.3% of subjects (17% veterinarians and 18% technicians) were MRSA positive. Colonized individuals originated from 5 different countries, predominantly the United States and Canada. Contact with small ruminants in the preceding 30 days (odds ratio [OR] 2.2), living with a person diagnosed with MRSA in the preceding year (OR 19.8) and working in a clinic where there is a specific person in charge of the infection control program (OR 2.2) were associated with colonization using multivariable analysis. Conclusion— The high rate of colonization identified here provides more evidence that MRSA exposure is likely an occupational risk for veterinary personnel. The equal rates in small animal and large animal personnel were surprising and contradict earlier studies indicating greater rates among equine personnel. The association of MRSA and small ruminant contact has not been reported previously. Clinical Relevance— MRSA is an important emerging pathogen in veterinary medicine and is a concern for both patients and veterinary personnel. The high colonization rate indicates the need to understand and control the spread of MRSA in veterinary clinics.  相似文献   

2.
OBJECTIVE: To evaluate the prevalence of nasal colonization with methicillin-resistant Staphylococcus aureus (MRSA) in horses and horse personnel. DESIGN: Prospective prevalence study. SAMPLE POPULATION: 972 horses and 107 personnel from equine farms in Ontario, Canada and New York state. PROCEDURE: Nasal swab specimens were collected from horses and humans on farms with (targeted surveillance) and without (nontargeted surveillance) a history of MRSA colonization or infection in horses during the preceding year. Selective culture for MRSA was performed. Isolates were typed via pulsed-field gel electrophoresis, and antibiograms were determined. RESULTS: MRSA was isolated from 46 of 972 (4.7%) horses (0/581 via nontargeted surveillance and 46/391 [12%] via targeted surveillance). Similarly, MRSA was isolated from 14 of 107 (13%) humans (2/41 [5%] from nontargeted surveillance and 12/66 [18%] from targeted surveillance). All isolates were subtypes of Canadian epidemic MRSA-5, an uncommon strain in humans. All isolates were resistant to at least 1 antimicrobial class in addition to beta-lactams. On all farms with colonized horses, at least 1 human was colonized with an indistinguishable subtype. For horses, residing on a farm that housed > 20 horses was the only factor significantly associated with MRSA colonization. For humans, regular contact with > 20 horses was the only identified risk factor. CONCLUSIONS AND CLINICAL RELEVANCE: Results confirm a reservoir of colonized horses on a variety of farms in Ontario and New York and provide evidence that 1 MRSA strain is predominantly involved in MRSA colonization in horses and humans that work with horses.  相似文献   

3.
Infection and colonization with methicillin-resistant Staphylococcus aureus (MRSA) are now increasingly being reported in animals and people who work with animals, including horses and horse personnel. The objectives of this study were to evaluate the prevalence of MRSA colonization in veterinary personnel attending an international equine veterinary conference, and to identify risk factors for MRSA colonization in this group. Volunteers were recruited at the conference to provide a single nasal swab and complete a questionnaire regarding contact with the human health care system, contact with horses, and personal hand hygiene. Colonization with MRSA was found in 26/257 (10.1%) of study participants. Multivariable analysis showed an increased risk of MRSA colonization associated with having been diagnosed with or having treated a patient diagnosed with MRSA colonization or infection in the last year (odds ratio [OR] 8.41, 95% confidence interval [CI] 1.51–49.92, P = 0.015; OR 3.27, 95% CI 1.05–10.11, P = 0.039, respectively), whereas hand washing between infectious cases (OR 0.27, 95% CI 0.11–0.72, P = 0.009) and hand washing between farms (OR 0.35, 95% CI 0.14–0.98, P = 0.047) were protective. The prevalence of MRSA colonization among equine veterinary personnel found in this study was high compared to that of other studies of the general population. These data support previous suggestions that equine veterinary personnel are at increased risk of colonization with MRSA. This is the first study to demonstrate a statistically significant association between hand hygiene practices and a measurable clinical outcome in veterinary medicine.  相似文献   

4.
Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging problem in horses; however, the epidemiology of infection and colonization is poorly understood. This study evaluated factors associated with MRSA colonization at the time of admission to a veterinary teaching hospital. A case-control study evaluating historical factors was performed. Previous colonization of the horse, previous identification of colonized horses on the farm, antimicrobial administration within 30 days, admission to the neonatal intensive care unit, and admission to a service other than the surgical service were risk factors for community-associated colonization. A better understanding of risk factors for MRSA colonization is important to elucidate the epidemiology of this emerging veterinary and zoonotic pathogen, and to design evidence-based infection control programs.  相似文献   

5.
OBJECTIVE: To describe MRSA infection and colonization in household pets, and transmission of MRSA between animals and humans. METHODS: MRSA infection and colonization in household pets and human contacts were evaluated during investigations initiated after identification of MRSA infection or colonization of a household pet in order to determine if there had been transmission between animals and humans. All MRSA isolates were screened for Panton-Valentine leukocidin (PVL) genes by use of polymerase chain reaction, and isolate relatedness was determined by use of pulsed-field gel electrophoresis (PFGE). RESULTS: Investigations of six situations where MRSA was identified in one or more animals in a household or veterinary facility were performed. MRSA was isolated from 8 animals (5 dogs and 3 cats) with clinical infections, 1 cat that was in contact with 2 infected cats and 14/88 (16%) of household contacts or veterinary personnel. Both animal-to-human and human-to-animal transmission were suspected. An indistinguishable MRSA isolate was recovered from at least one human that was in contact with each animal case. All isolates were classified as Canadian epidemic MRSA-2, the predominant community-associated MRSA clone in humans in Canada. No isolates possessed genes encoding for the PVL. CONCLUSIONS: Transmission of MRSA between humans and animals, in both directions, was suspected. MRSA appears to be an emerging veterinary and zoonotic pathogen.  相似文献   

6.
Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging equine pathogen. To attempt to control nosocomial and zoonotic transmission, an MRSA screening program was established for all horses admitted to the Ontario Veterinary College Veterinary Teaching Hospital, whereby nasal screening swabs were collected at admission, weekly during hospitalization, and at discharge. MRSA was isolated from 120 (5.3%) of 2,283 horses: 61 (50.8%) at the time of admission, 53 (44.2%) during hospitalization, and 6 from which the origin was unclear because an admission swab had not been collected. Clinical infections attributable to MRSA were present or developed in 14 (11.7%) of 120 horses. The overall rate of community-associated colonization was 27 per 1,000 admissions. Horses colonized at admission were more likely to develop clinical MRSA infection than those not colonized at admission (OR 38.9, 95% CI 9.49 160, P < 0.0001). The overall nosocomial MRSA colonization incidence rate was 23 per 1,000 admissions. The incidence rate of nosocomial MRSA infection was at the rate of 1.8 per 1,000 admissions, with an incidence density of 0.88 per 1,000 patient days. Administration of ceftiofur or aminoglycosides during hospitalization was the only risk factor associated with nosocomial MRSA colonization. MRSA screening of horses admitted to a veterinary hospital was useful for identification of community-associated and nosocomial colonization and infection, and for monitoring of infection control practices.  相似文献   

7.
Fortunately, MRSA infection and colonization are currently uncommon in veterinary medicine. Nevertheless, the increasing reports of the occurrence of MRSA infection in horses, veterinarians, and equine personnel dictate that serious consideration be given to the control of this pathogen in veterinary hospitals as well as in the equine community. It is unclear whether extrapolation from human hospitals and people in the community is appropriate; however, given the rapid increase in nosocomial MRSA in human hospitals and the recent shift of certain clones of MRSA into the community, it would be unwise to ignore this potential pathogen. If equine MRSA did, indeed, originate in the human population, complete eradication in the equine population is unlikely, regardless of the prevalence of infection in horses and the intensity of infection control measures, without concurrent eradication of MRSA in the human population, which is surely an impossible feat. Early institution of appropriate surveillance and other infection control measures should be used to attempt to limit the impact of MRSA in veterinary medicine, however. It has been stated, "The time to act is now, before the prevalence of MRSA in the community begins to rise and we end up with 50% of the community strains becoming methicillin-resistant". This statement was directed at control of MRSA in people; however, it is equally relevant in the veterinary context and should receive strong consideration.  相似文献   

8.
Methicillin resistant Staphylococcus aureus (MRSA) colonization has recently been identified in pigs and people that work with pigs, raising concerns about the role of pigs as reservoirs of MRSA for human infection. The objectives of this study were to evaluate the prevalence of MRSA colonization in pigs and pig farmers in Ontario, Canada and to characterize MRSA strains. Nasal and rectal swabs were collected from 285 pigs from three different age groups from 20 pig farms. Nasal swabs were collected from farm personnel and a brief questionnaire was also administered. The prevalence of MRSA colonization in farms was 45% (9/20) whereas the prevalence in pigs was 24.9% (71/285). There was no difference in MRSA colonization between age groups. The prevalence of MRSA colonization in pig farmers was 20% (5/25). There was a correlation between the presence of MRSA in pigs and humans on farms (P value=0.001). The results of spa typing revealed the predominant strain in pigs and humans was eGenomics spa type 539 (Ridom t034, clonal complex 398) which accounted for 59.2% of isolates and has been reported in pigs in Europe. A common human epidemic clone, CMRSA-2 (USA100, clonal complex 5) was also found in both pigs and pig personnel. Indistinguishable strains were found in pigs and pig personnel on all five farms with a colonized human. This study demonstrates that MRSA is common in pigs in Ontario, Canada, and provides further support to concerns about transmission of MRSA between pigs and humans.  相似文献   

9.
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10.
Reports of methicillin-resistant Staphylococcus aureus (MRSA) in animals have become more frequent in recent years. This paper documents the recovery of MRSA from animals with respiratory, urinary tract or wound infection and from animals subjected to surgical procedures following treatment in one veterinary hospital and 16 private veterinary clinics in different geographical locations throughout Ireland. MRSA was recovered from 25 animals comprising 14 dogs, eight horses, one cat, one rabbit and a seal, and also from 10 attendant veterinary personnel. Clinical susceptibility testing suggested that the 35 isolates fell into two different groups. One group of isolates (Group 1) was resistant to one or more of the following classes of antimicrobials: macrolides, lincosamines, tetracyclines and/or fluoroquinolones. The second group (Group 2) was resistant to macrolides, aminoglycosides, tetracyclines and trimethoprim/sulphamethoxazole and variably resistant to fluoroquinolones, lincosamines and rifampicin. One isolate in Group 2 was susceptible to trimethoprim. Epidemiological typing by antibiogram-resistogram (AR) typing, biotyping and by chromosomal DNA restriction fragment length polymorphism analysis using SmaI digestion followed by pulsed field gel electrophoresis (PFGE), confirmed these two major clusters. PFGE analysis showed that most isolates from non-equine animals were indistinguishable from each other and from the isolates from personnel caring for these animals. MRSA was isolated from eight horses which attended six different veterinary practices before referral to an equine veterinary hospital. Isolates from the eight horses and from their attendant personnel had PFGE patterns that were indistinguishable and were unlike the patterns obtained from the other isolates. Comparison of PFGE patterns of isolates from veterinary sources with patterns from MRSA recovered in human hospitals showed that the most frequently occurring pattern of MRSA from non-equine animals was indistinguishable from the predominant pattern obtained from the most prevalent MRSA strain in the human population in Ireland. However, the patterns of the isolates from horses were unlike any patterns previously reported in Irish studies of human isolates. This study shows that transmission of two strains of MRSA is occurring in veterinary practices in Ireland and that one strain may have arisen from human hospitals. The source of the second strain remains to be determined.  相似文献   

11.
REASONS FOR PERFORMING STUDY: Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging equine and zoonotic pathogen. Infection control protocols can be used to control MRSA in human hospitals, but measures to eradicate MRSA on horse farms have not been evaluated. OBJECTIVES: To describe an MRSA eradication programme that was used to attempt to eliminate MRSA colonisation among horses and horse personnel on 2 equine farms. METHODS: Active surveillance cultures and infection control protocols were implemented on 2 farms with endemic MRSA. RESULTS: Active screening and strict implementation of infection control protocols resulted in a rapid decrease in number of colonised horses on both farms. The majority of horses eliminated MRSA without antimicrobial treatment. On one farm colonisation was eradicated, while only 2 (3%) colonised horses remained on the other farm at the end of the study. CONCLUSIONS: Although at this stage the benefit of eradication of MRSA from populations of horses and cost-benefit studies have not been established, this study illustrates that short-term eradication can be achieved with a policy of segregation, enhanced infection control precautions and repeated testing of groups of animals. POTENTIAL RELEVANCE: Infection control practices should form the basis of MRSA control. Antimicrobial therapy does not appear to be required for eradication of MRSA colonisation in horses and control of MRSA on farms. In appropriate circumstances, these methods may be useful for controlling the spread of this potentially serious pathogen.  相似文献   

12.
The objectives of this paper are to review published data on the prevalence and epidemiology of meticillin-resistant Staphylococcus aureus (MRSA) infection and colonization in animals and to provide suggestions for preventing and controlling the problem in veterinary practice. MRSA first emerged as a serious pathogen in human medicine during the late 1970s and has been increasingly reported in animals during the past 10 years. The prevalence of MRSA in human infections varies markedly between geographical areas, being as high as 60% in parts of the USA, 40% in southern Europe but <1% in northern Europe. Epidemiological evidence, including phenotypic and molecular typing data, suggests that MRSA isolates from dogs and cats are indistinguishable from human healthcare isolates, whereas strains of MRSA isolated from horses and associated personnel are different. There is evidence that transfer of MRSA strains can occur between animals and humans and vice versa. Guidelines for the control of MRSA in animals have been drawn up by individual institutions based on those available for human MRSA infection. Risk factors for MRSA infection in animals are currently under investigation and such data are essential for the preparation of specific guidelines for control of MRSA in veterinary practice.  相似文献   

13.
Elevated rates of methicillin‐resistant Staphylococcus aureus (MRSA) carriage have been reported in veterinary personnel, suggesting an occupational colonization risk. Hong Kong veterinary personnel (n = 150) were sampled for coagulase‐positive staphylococci (CPS) nasal colonization. Risk factors for colonization were assessed by questionnaire. Isolates were identified and antibiotic susceptibility determined. All CPS isolates were investigated for mecA carriage, SCCmec type and PVL genes. Two subjects were colonized with methicillin‐resistant CPS: one with MRSA (spa type t002 (CC5), SCCmec type II) and one with methicillin‐resistant Staphylococcus pseudintermedius (MRSP) (MLST type ST71, SCCmec type II‐III). MLST type ST71 S. pseudintermedius strain is the predominant MRSP clone circulating in dogs in Europe and in Hong Kong. The low MR‐CPS colonization rate may be associated with low levels of large animal exposure or low rates of MRSA colonization of companion animals in Hong Kong. Colonization with non‐aureus CPS, which may cause human infection, must also be considered in veterinary personnel.  相似文献   

14.
Veterinary practices are unique environments that bring humans into close contact with many different species of animals; therefore, the risk of exposure to infectious pathogens is inherently different in veterinary medicine than in human medicine. In contrast to the risk of exposure to blood in human medicine, infections from zoonotic diseases in veterinary personnel are primarily related to exposure to animal faeces, infected skin, wounds, droplets and puncture wounds. Infection-control measures in veterinary practices are often insufficient to prevent zoonotic disease transmission. The Veterinary Standard Precautions (VSP) Compendium is designed to help prevent transmission of zoonotic pathogens from animal patients to veterinary personnel in private practice.  相似文献   

15.
Given the significance of methicillin-resistant Staphylococcus aureus (MRSA) infections for both horses and staff in equine veterinary hospitals, protocols are required to minimise the risk of nosocomial transmission, including the screening of the skin and nasal chambers of equine patients for evidence of infection. The objective of this study was to clarify the potential existence and extent of MRSA on the skin of horses requiring long-term hospitalisation (?6months). Thirty such horses were sampled at eight different locations on their skin and from their nasal chambers. MRSA was isolated from 12 animals (40%), with all sample sites testing positive on at least one occasion. Organisms were most frequently detected in the nasal chambers (relative sensitivity, 83.3%; 34.5% positive horses; isolation rate 33.3%). Skin presence was found in 30% of animals with the highest isolation rates found at the carpus (16.7%), neck, withers and croup (13.3% each). To achieve a relative screening sensitivity of >90%, at least one skin site was required in addition to nasal sampling. This evidence of skin as well as nasal reservoirs of MRSA in long-term hospitalised horses should facilitate the design of effective screening and containment protocols.  相似文献   

16.
Objective – To familiarize the reader with the epidemiology, diagnosis, and infectious and zoonotic potential of methicillin-resistant staphylococci.
Data sources – Original research publications, scientific reviews and abstracts, case reports, and conference proceedings.
Human Data Synthesis – Staphylococcus aureus is a common human commensal organism; acquisition of genes encoding an altered penicillin-binding protein confers resistance to β-lactam antimicrobial drugs. Methicillin-resistant S. aureus (MRSA) are often resistant to non–β-lactam antimicrobial drugs as well. Originally described as an important cause of nosocomial infection, MRSA colonization and infection are now often identified in humans outside healthcare settings. Like other S. aureus , MRSA may be present without clinical illness. However, when they do cause infection the consequences can be extremely serious.
Veterinary Data Synthesis – The major domestic animal species, including pets and livestock, may become contaminated, colonized, or infected with methicillin-resistant staphylococci, including MRSA. Dogs and cats are more likely to be colonized/infected with Staphylococcus pseudintermedius than S. aureus , but this pathogen can acquire genes encoding methicillin resistance (ie, MRSP). Diagnosis of MRSA or MRSP has implications not only for treatment of infected animals, but for potential zoonotic transmission.
Conclusions – MRSA infection is an important cause of morbidity and mortality in humans. Animals may be contaminated, colonized, or infected with MRSA, with implications for the animal's health and as a potential reservoir for human infection. Staphylococci other than S. aureus may also acquire genes for methicillin resistance, and these species can also result in animal and occasionally human morbidity or mortality.  相似文献   

17.
Objective To evaluate if methicillin‐resistant Staphylococcus aureus (MRSA) is present in the horse population in Australia. Design A two‐part retrospective study of laboratory submissions of microbial culture results from horses. Methods Part A: medical records of 216 horses that had MRSA screening performed on nasal swabs collected over a 30‐day period at admission to the Scone Equine Hospital Clovelly Intensive Care Unit were retrieved. Part B: laboratory records from 2004 to 2009 of culture submissions to the Scone Veterinary Laboratory were reviewed and cultures that grew MRSA were identified. The MRSA isolates from Parts A and B were genotyped over an 18‐month period. Results MRSA screening of 216 horses identified eight (3.7%) positive samples. MRSA was isolated from cultures of 80 (0.002%) clinical bacteriology samples over a 6‐year period. Genotypic analysis was performed on 36 isolates. All MRSA characterised had the same pulse field gel electrophoresis pattern (type 1), with eight closely related subtypes identified (subtypes A–F and H) and 66% of isolates classified as subtype D, which multilocus sequence and staphylococcal cassette chromosome mec typing analysis identified as ST612‐MRSA‐IVa, a clonal complex (CC) 8 S. aureus strain. Antimicrobial resistance to more than two classes of antimicrobials was common. Conclusions MRSA was present in a population of horses in Australia. Genotypic analysis of the isolates identified the MRSA strain as CC8 S. aureus. Further research needs to be undertaken to evaluate MRSA infection and colonisation of horses and personnel in Australia.  相似文献   

18.
Screening for nasal colonization is an important aspect of many methicillin-resistant Staphylococcus aureus (MRSA) control programs. Real-time polymerase chain reaction (RT-PCR) is an attractive alternative to standard culture techniques because of the considerably shorter turnaround time. An assay has been validated for diagnostic purposes in humans, however this methodology has not been evaluated in horses. The purpose of this study was to compare an RT-PCR assay for rapid identification of MRSA directly from nasal swabs in horses to standard culture techniques. Nasal swabs collected from 293 horses were processed using a commercial RT-PCR assay (IDI-MRSA, GeneOhm Sciences, San Diego, CA) according to the manufacturer's instructions. The swabs were also cultured and MRSA was identified according to standard protocols. Initially only 176/293 samples yielded valid PCR results. Two of 176 and 167/176 samples were positive and negative, respectively, by both PCR and culture. Seven of 176 samples were positive by PCR and negative by culture, whereas 0/176 samples were negative by PCR and positive by culture. The kappa statistic was 0.35, which represented poor agreement between the tests. Of the remaining 117 samples, 105 samples were initially reported as "unresolved". Following one freeze-thaw cycle of the lysates, the recommended technique to resolve such samples, 61/110 (55%) samples remained unresolved. In this study, the IDI-MRSA assay was not a clinically practical screening test for horses harbouring nasal MRSA. Its agreement with culture was poor and the high unresolved rate (37%) also significantly decreased the clinical utility of the test.  相似文献   

19.
Methicillin‐resistant Staphylococcus aureus (MRSA) is an emerging cause of serious bacterial infection in the horse, with an increasing number of cases reported over the last decade. MRSA, along with other commensal staphylococcal species, can reside on the mucosa of several sites in the horse, particularly the nose. Nasal carriage of MRSA appears rare amongst horses in the community, although a higher prevalence has been found in hospitalised horses. MRSA infections can involve a variety of body sites, but most commonly encountered are soft tissue infections of either traumatic or surgical wounds. MRSA strain types isolated from horses are typically multidrug‐resistant and usually differ from those recovered from humans and other small animal species. Treatment of infection can be prolonged and is dependent on timely, accurate diagnosis and on appropriate therapy; often guided by antimicrobial susceptibility testing. The purpose of this review is to provide clinically relevant information for the equine practitioner and, for illustration, the diagnosis, treatment and outcome of 4 clinical cases of MRSA infection in horses is discussed.  相似文献   

20.
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