Livestock-associated MRSA carriage in patients without direct contact with livestock

PLoS One. 2014 Jun 27;9(6):e100294. doi: 10.1371/journal.pone.0100294. eCollection 2014.


Background: Livestock-associated MRSA (MC398) has emerged and is related to an extensive reservoir in pigs and veal calves. Individuals with direct contact with these animals and their family members are known to have high MC398 carriage rates. Until now it was assumed that MC398 does not spread to individuals in the community without pig or veal calf exposure. To test this, we identified the proportion of MC398 in MRSA positive individuals without contact with pigs/veal calves or other known risk factors (MRSA of unknown origin; MUO).

Methods: In 17 participating hospitals, we determined during two years the occurrence of MC398 in individuals without direct contact with livestock and no other known risk factor (n = 271) and tested in a post analysis the hypothesis whether hospitals in pig-dense areas have higher proportions of MC398 of all MUO.

Results: Fifty-six individuals (20.7%) without animal contact carried MC398. In hospitals with high pig-densities in the adherence area, the proportion of MC398 of all MUO was higher than this proportion in hospitals without pigs in the surroundings.

Conclusions: One fifth of the individuals carrying MUO carried MC398. So, MC398 is found in individuals without contact to pigs or veal calves. The way of transmission from the animal reservoir to these individuals is unclear, probably by human-to-human transmission or by exposure to the surroundings of the stables. Further research is needed to investigate the way of transmission.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Carrier State / epidemiology*
  • Carrier State / microbiology*
  • Geography
  • Hospitals / statistics & numerical data
  • Humans
  • Livestock / microbiology*
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification
  • Methicillin-Resistant Staphylococcus aureus / physiology*
  • Netherlands / epidemiology
  • Risk Factors
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / microbiology*
  • Sus scrofa

Grant support

This work was supported by The Netherlands Organisation for Health Research and Development [grant number 125020007]. ZonMw is a non-profit organisation working for the Ministry of Health, Welfare and Sport (VWS) and the Dutch Organisation for Scientific Research (NOW). ZonMw had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.