Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, CESP, Anti-infective evasion and pharmacoepidemiology team, F-78180, Montigny-Le-Bretonneux, France; Institut Pasteur, Epidemiology and Modelling of Antibiotic Evasion unit, F-75015, Paris, France; MESuRS Laboratory, Conservatoire National des Arts et Métiers, 292 Rue Saint-Martin, 75003 Paris, France; PACRI Unit, Conservatoire National des Arts et Métiers, Institut Pasteur, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
Ploufragan Plouzané Niort Laboratory, Epidemiology, Health and Welfare Research Unit, Anses, BP 53, 22440 Ploufragan, France; Université Bretagne Loire, Cité internationale, 1 place Paul Ricoeur CS 54417, 35044 Rennes, France.
Epidemics. 2020 Jun;31:100389. doi: 10.1016/j.epidem.2020.100389. Epub 2020 Feb 9.
Livestock-associated methicillin resistant Staphylococcus aureus (LA-MRSA) colonizes livestock animals worldwide, especially pigs and calves. Although frequently carried asymptomatically, LA-MRSA can cause severe infections in humans. It is therefore important to better understand LA-MRSA spreading dynamics within pig farms and over pig movement networks, and to compare different strategies of control and surveillance. For this purpose, we propose a stochastic meta-population model of LA-MRSA spread along the French pig movement network (n = 10,542 farms), combining within- and between-farm dynamics, based on detailed data on breeding practices and pig movements between holdings. We calibrate the model using French epidemiological data. We then identify farm-level factors associated with the spreading potential of LA-MRSA in the network. We also show that, assuming control measures applied in a limited (n = 100) number of farms, targeting farms depending on their centrality in the network is the only way to significantly reduce LA-MRSA global prevalence. Finally, we investigate the scenario of emergence of a new LA-MRSA strain, and find that the farms with the highest indegree would be the best sentinels for a targeted surveillance of such a strain's introduction.
牲畜相关耐甲氧西林金黄色葡萄球菌（LA-MRSA）在全球范围内定殖于牲畜动物中，尤其是猪和小牛。尽管通常无症状携带，但 LA-MRSA 可导致人类严重感染。因此，了解猪场内和猪移动网络中 LA-MRSA 的传播动态，并比较不同的控制和监测策略非常重要。为此，我们提出了一种基于法国猪移动网络（n=10542 个农场）的 LA-MRSA 传播的随机元种群模型，该模型结合了农场内和农场间的动态，基于养殖实践和农场间猪移动的详细数据。我们使用法国的流行病学数据对模型进行了校准。然后，我们确定了与网络中 LA-MRSA 传播潜力相关的农场级因素。我们还表明，假设在有限数量的（n=100）农场中实施控制措施，根据其在网络中的中心性来靶向农场是降低 LA-MRSA 全球流行率的唯一方法。最后，我们研究了新的 LA-MRSA 菌株出现的情景，并发现具有最高入度的农场将是针对此类菌株引入进行有针对性监测的最佳哨点。
