Clusters of 398 are growing around pig farms. The report below gives the bare facts.It would be interesting to know whether work was done to clarify how many of the carriers worked in farming.
Of the 498 new MRSA patients identified (65% with screening; 35% unexpected carriers) 31% carried ST398 MRSA (92% detected through screening). The overall prevalence of MRSA in the screened population was 3.6% (95%-BI: 3.2-4.0). Prevalence were 2.5% (95%-BI: 1.9-3.1), 3.8% (95%-BI: 3.1-4.5; p=0.007) and 4.6% (95%-BI: 3.7-5.5; p=0.000), respectively, in low, moderate and high pig density region hospitals. Prevalence of ST398 MRSA was 12.4% in patients screened in hospitals in regions with a high or moderate pig density and 0% in hospitals in regions with a low pig density. The prevalence of other MRSA isolates in patients screened in these hospitals was between 1.1 – 2.9%. In post-exposure screenings, unrelated ST398 MRSA carriers (index case had different genotype) were found in 0.06% (3/4794) of HCWs and none of the patients (0/1951). Other MRSA isolates (genotype different from index case and excluding ST398) were detected in 0.1% (8/5758) of HCWs and 0.5% (10/2134) of patients.
Conclusion: In this first large survey of ST398 MRSA in Dutch hospitals we found that MRSA is more prevalent in regions with a high or moderate pig density, solely because of an increase of ST398 MRSA. Almost 80% of new carriers are detected in out-patient departments and 92% because of active surveillance. ST398 MRSA colonization is rarely encountered in HCWs and patients during post-exposure screenings of index cases with different genotypes.
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