Höjgård Sören, Aspevall Olov, Bengtsson Björn, Hæggman Sara, Lindberg Maria, Mieziewska Kristina, Nilsson Svante, Ericsson Unnerstad Helle, Viske Diana, Wahlström Helene
Swedish University for Agricultural Sciences, and AgriFood Economics Centre, Uppsala, Sweden.
Public Health Agency of Sweden, Solna, Sweden.
PLoS One. 2015 Apr 29;10(4):e0122875. doi: 10.1371/journal.pone.0122875. eCollection 2015.
Antibiotic resistance is a growing concern in human, as well as in veterinary medicine. Part of the problem concerns how to respond to the risk presented by animal reservoirs of resistant bacteria with the potential of spreading to humans. One example is livestock associated methicillin-resistant Staphylococcus aureus (LA-MRSA). In countries where LA-MRSA is endemic in the pig population, people in contact with pigs have a higher risk of being colonised with LA-MRSA, and persons from this group are subjected to precautionary measures when visiting health care facilities. In the present study, it is assumed that, if LA-MRSA was introduced to the Swedish pig population, the prevalence in the risk groups would be the same as in Denmark or the Netherlands (two countries with low human prevalence that have implemented measures to detect, trace and isolate human LA-MRSA cases and, therefore, have comprehensive data with good coverage regarding prevalence of LA-MRSA), and that similar interventions would be taken in Swedish health care facilities. It is also assumed that the Swedish pig population is free of MRSA or that the prevalence is very low. We analyse if it would be efficient for Sweden to prevent its introduction by testing imported live breeding pigs. Given that quarantining and testing at import will prevent introduction to the pig population, the study shows that the preventive measures may indeed generate a societal net benefit. Benefits are estimated to be between € 870 720 and € 1 233 511, and costs to € 211 129. Still, due to gaps in knowledge, the results should be confirmed when more information become available.
抗生素耐药性在人类医学和兽医学领域都日益受到关注。部分问题在于如何应对耐药菌动物宿主带来的风险，这些耐药菌有可能传播给人类。一个例子是家畜相关的耐甲氧西林金黄色葡萄球菌（LA-MRSA）。在LA-MRSA在猪群中呈地方性流行的国家，与猪接触的人感染LA-MRSA的风险更高，并且该群体中的人在前往医疗保健机构时会采取预防措施。在本研究中，假设如果LA-MRSA被引入瑞典猪群，风险群体中的流行率将与丹麦或荷兰相同（这两个国家人类流行率较低，已实施检测、追踪和隔离人类LA-MRSA病例的措施，因此拥有关于LA-MRSA流行率的全面且覆盖良好的数据），并且瑞典的医疗保健机构会采取类似的干预措施。还假设瑞典猪群中不存在MRSA或流行率非常低。我们分析瑞典通过检测进口种猪来预防其引入是否有效。鉴于进口时的检疫和检测将防止其引入猪群，研究表明这些预防措施确实可能产生社会净效益。效益估计在870720欧元至1233511欧元之间，成本为211129欧元。不过，由于知识上的差距，当有更多信息可用时，结果应予以确认。
