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MRSA in persons not living or working on a farm in a livestock-dense area: prevalence and risk factors.

Zomer, T.P., Wielders, C.C.H., Veenman, C., Hengeveld, P., Hoek, W. van der, Greeff, S.C. de, Smit, L.A.M., Heederik, D.J., Yzermans, C.J., Bosch, T., Maassen, C.B.M., Duijkeren, E. van. MRSA in persons not living or working on a farm in a livestock-dense area: prevalence and risk factors. Journal of Antimicrobial Chemotherapy: 2017, 72(3), 893-899
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Objectives
MRSA emerged in livestock and persons in contact with livestock is referred to as livestockassociated MRSA (LA-MRSA). We assessed the prevalence and risk factors for MRSA carriage in persons not living or working on a farm.

Methods
A cross-sectional study was performed among 2492 adults living in close proximity of livestock farms. Persons working and/or living on farms were excluded. Nasal swabs were cultured using selective media. Participants completed questionnaires and the distance from the residential address to the nearest farm was calculated. The Mann-Whitney U-test was used to compare median distances. Risk factors were explored with logistic regression.

Results
Fourteen persons carried MRSA (0.56%; 95% CI 0.32%-0.92%), 10 of which carried LA-MRSA of multiple-locus variable-number tandem repeat analysis complex (MC) 398 (0.40%; 95% CI 0.20%-0.71%). MRSA MC 398 carriers lived significantly closer to the nearest farm than non-carriers (median: 184 versus 402 m; P < 0.01). In bivariate analyses correcting for contact with livestock, this difference remained significant.

Conclusions
Although the prevalence was low, living near farms increased the risk of MRSA MC 398 carriage for persons not living or working on a farm. Further research is necessary to identify the transmission routes. (aut. ref.)