Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, North Mymms, Hertfordshire AL9 7TA, UK.
J Hosp Infect. 2010 Mar;74(3):282-8. doi: 10.1016/j.jhin.2009.09.020. Epub 2010 Jan 18.
Meticillin-resistant Staphylococcus aureus (MRSA) nasal carriage on admission to hospital remains one of the most important risk factors for subsequent infection. Identification of high risk groups for MRSA carriage is vital for the success of infection control programmes. Veterinary staff may be one such risk group but little is known about pet owners and the role of contact with infected pets. As part of a UK-wide case-control study investigating risk factors for MRSA infection in dogs and cats between 2005 and 2008, 608 veterinary staff and pet owners in contact with 106 MRSA and 91 meticillin-susceptible S. aureus (MSSA)-infected pets were screened for S. aureus nasal carriage. Laboratory isolation and characterisation included salt broth enrichment, standard and automated microbiological tests, demonstration of the S. aureus-specific thermonuclease gene (nuc) and of mecA, and polymerase chain reaction-based lineage characterisation. MRSA carriage was 12.3% in veterinarians attending MRSA-infected animals and 7.5% in their owners. In the MSSA control group, MRSA carriage was 4.8% in veterinary staff and 0% in owners. Veterinary staff carried MRSA more frequently than owners (odds ratio: 2.33; 95% confidence interval: 1.10-4.93). All MRSA from humans and all but one animal MRSA were CC22 or CC30, typical for hospital MRSA in the UK. This study indicates for the first time an occupational risk for MRSA carriage in small animal general practitioners. Veterinary staff and owners of MRSA-infected pets are high risk groups for MRSA carriage despite not having direct hospital links. Strategies to break the cycle of MRSA infection must take these potential new reservoirs into account.
耐甲氧西林金黄色葡萄球菌(MRSA)定植于入院时的鼻腔,仍是后续感染的最重要危险因素之一。确定 MRSA 定植的高危人群,对于感染控制计划的成功至关重要。兽医人员可能就是高危人群之一,但对于宠物主人及其与感染宠物的接触在其中的作用,人们了解甚少。2005 年至 2008 年间,英国开展了一项针对犬猫 MRSA 感染危险因素的全国性病例对照研究,作为该研究的一部分,研究人员共筛查了 608 名与 106 株 MRSA 和 91 株耐甲氧西林金黄色葡萄球菌(MSSA)感染宠物有接触的兽医人员和宠物主人,以确定其鼻腔是否定植了金黄色葡萄球菌。实验室分离和鉴定包括盐肉汤增菌、标准和自动化微生物学检测、金黄色葡萄球菌特异性热核酸酶基因(nuc)和 mecA 检测、以及基于聚合酶链反应的谱系特征检测。在接触 MRSA 感染动物的兽医中,MRSA 定植率为 12.3%,在其主人中为 7.5%。在 MSSA 对照组中,兽医人员的 MRSA 定植率为 4.8%,而其主人中为 0%。兽医人员携带 MRSA 的频率高于主人(比值比:2.33;95%置信区间:1.10-4.93)。人类来源的所有 MRSA 和除一株动物来源的 MRSA 以外,均属于 CC22 或 CC30 型,这与英国医院 MRSA 流行株一致。本研究首次表明,小型动物全科兽医存在职业性 MRSA 定植风险。尽管兽医人员和 MRSA 感染宠物的主人与医院没有直接联系,但他们属于 MRSA 定植的高危人群。打破 MRSA 感染循环的策略必须考虑到这些潜在的新感染源。