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2009 PPT Presentation at ASM ESCMID Conference in London, UK.
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Abby L. Harper, MPHUniversity of Iowa
Center for Emerging Infectious Diseases
10-09-2009
Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in organic and confinement swine
operations in Iowa and Illinois
Introduction to MRSA
Methicillin-resistant Staphylococcus aureus (MRSA)
Gram positive bacterium
Leading cause of hospital-associated infections
Image: http://trouble.philadelphiaweekly.com/archives/MRSA220207_400x379%5B1%5D.jpg
Introduction to MRSA
Not only a hospital problem anymore
Reference: NEJM 2005;352:468-75NEJM 2008;358:11.
Images: : http://www.foodpoisonblog.com/dog_cat.jpg http://agebb.missouri.edu/commag/swine/pigs.jpghttp://www.smh.com.au/ffximage/2006/07/26/cattle26706_wideweb__470x313,0.jpg
MRSA and Swine
First identified in the Netherlands, 2005
Pig farmers: higher rate of colonization with methicillin-susceptible S. aureus (MSSA) and MRSA
Reference: EID 2005;11:1965-66
MRSA and Swine
Swine-associated MRSA also found in Denmark, Germany, Austria, France, Canada
USA?
Swine MRSA in the USA?
Iowa: #1 pork producing state in the USA
16 million hogs
= 25% of hogs raised in the U.S.
= $4 billion/year
Image: http://en.wikipedia.org/wiki/Iowa
MULTI-STATE STUDY
Images: http://en.wikipedia.org/wiki/Iowahttp://en.wikipedia.org/wiki/Minnesotahttp://en.wikicpedia.org/wiki/Ohiohttp://wonkette.com/340314/ongoing-wonkette-iowa-caucus-coverage/
Multi-state study 18 farms per investigator
24 animals tested per farm
Nasal + pharyngeal sampling, humans
17 farms tested
Summary – Results in Swine
No MRSA found to date on organic farms in Iowa
Overall prevalence, swine: 45/408 (11%) Confinement swine: 45/192 (24%)
Humans: 27/86 (31.4%)
Humans working in confinement: 27/61 (44.3%)
Confirmed as ST398; first identification in US
Summary – Results in Humans
Individuals exposed to swine, especially in confinement
operations, are at risk for MRSA carriage
Images: http://brhssupplies.com/db1/00097/brhssupplies.com/_uimages/P1011023.JPGhttp://cache.daylife.com/imageserve/05C1f8NfK3eZ5/610x.jpg
Confinements as amplifiers and reservoirs
1000s of animals in small space
Ventilation systems
Low-tech environmental sampling
All but 1 grew MRSA Map created by: Abby L. HarperSources: Abby HarperIowa Geologic Survey – DNR
Follow-up Environmental Sampling PhD student in
Industrial Hygiene
Anderson impact sampler
CFUs / volume of air
May indicate MRSA particle size
Source: http://www.teagasc.ie/research/reports/dairyproduction/3989/eopr-3989.asphttp://www.pacwill.ca/en/ProductsServices/6stage.htm
Summary MRSA is present in
U.S. swine and swine workers in confinement facilities
Potential to spread to larger community
Reservoir of resistance
Image: http://cuteoverload.com/2009/04/27/pucker-up-behbeh/
Future directions
More general study of MRSA in rural Iowa
Population prevalence & strain types
Animals other than swine
Role of antibiotics?
Co-authors and team membersTara Smith (PI)
Mike Male, Anne Dressler,Blake Hanson, Shylo Wardyn (MS students)
Jennifer Kroeger (PhD student)Phil Scheibel (undergraduate)
Loreen Herwaldt MD, Dan Diekema MD (UIHC)
http://www.public-health.uiowa.edu/CEID/abby-harper@uiowa.edu
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