Thema: Diabetes mellitus en infectieziekten Het ... - NVMM

in household members of pig- and veal farmers arelower than those in farmers themselves (4-8% versus20-40%), but substantially higher than in the generalDutch population (0.1%). The aim of this prospectivecohort study was to further elucidate the dynamics anddeterminants of LA-MRSA carriage in household membersof pig farmers. In total, 171 household members living on50 Dutch pig farms were included in the study. On sixsampling moments in a one-year period, repeated humanand environmental samples were taken, and questionnaireswere completed. The mean MRSA prevalence inhousehold members per sampling moment was 10%,4% of household members were persistently carryingMRSA. All stables, 63% of the home environments, and74% of dogswere MRSA-positive. Multivariate analysisidentified working in the stables (prevalence ratio (PR)2.11 per 10 hours per week, p-value 0.00), working withsows (PR 1.97, p 0.00), and presence of an MRSA-positivepig farmer (PR 4.62, p 0.02) as independent risk factorsfor a MRSA positive sample during the study. MethicillinsusceptibleStaphylococcus aureus (MSSA) nasal carriagewas a significant protective factor (PR 0.50, p 0.02). Thiscohort study shows that MSSA carriage protects householdmembers of pig farmers from MRSA acquisition, and thatcontact with pigs and MRSA positive pig farmers are themost important risk factors. Whether human-to-humantransmission occurs, or LA-MRSA acquisition is alwaysdue to animal contact, remains to be disclosed.Livestock-associated MRSA does not add substantiallyto the disease-burden caused by StaphylococcusaureusB.A.G.L. van Cleef 1,2 , B.H.B. van Benthem 1 , A.P.J. Haenen 1 ,J. Monen 1 , T. Bosch 1 , J.A.J.W. Kluytmans 2,31 Centre for Infectious Disease Control Netherlands, RIVMNational Institute for Public Health and the Environment,Bilthoven, 2 Laboratory for Medical Microbiology and InfectionPrevention, St. Elisabeth Hospital, Tilburg, 3 Department ofMedical Microbiology and Infection Control, VU UniversityMedical Centre, AmsterdamWe describe the incidence of livestock-associatedmethicillin-resistant Staphylococcus aureus (LA-MRSA)bacteraemia compared to bacteraemia with other MRSAvariants and all S. aureus. This shows the limited burdenof disease caused LA-MRSA.MRSA is a worldwide problem in both hospitals andcommunities all over the world. Since 2005 a new MRSAclade has emerged, with a reservoir in pigs and veal calves:LA-MRSA. We wanted to estimate the current incidenceof invasive infections due to LA-MRSA using the nationalantibiotic resistance surveillance system ISIS-AR from theyear 2009 in the Netherlands. We found a low incidenceof LA-MRSA bacteraemia episodes, compared to bacteraemiascaused by MRSA in general or all S. aureus(0.04, 0.18 and 19.3 episodes of bacteraemia per 100,000inhabitants per year, respectively). Our findings show thatthe disease-burden of MRSA, including LA-MRSA, is verylow (approximately 1%) compared to the total burden ofdisease caused by S. aureus. This may be explained by acombination of reduced virulence of the strain involved,the effectiveness of the search and destroy policy forMRSA in the Netherlands and the good health status ofthe population that is affected with LA-MRSA. At presentthe impact of MRSA, including LA-MRSA, for the Dutchpopulation is very limited.Prevalentie van Staphylococcus aureus-neusdragerschapbij chirurgen en chirurgen in opleidingin NederlandJ.L.A. van Vugt 1 , R.J.S. Coelen 1 , J.P.M. Derikx 1,3 , D.W. vanDam 2 , J.H.M.B. Stoot 11 Afdeling Chirurgie, Orbis Medisch Centrum, Sittard,2 afdeling Medische Microbiologie, Orbis Medisch Centrum,Sittard, 3 afdeling Chirurgie, Maastricht Universitair MedischCentrum, MaastrichtStaphylococcus aureus-neusdragerschap bij patiënten iseen bekende bron voor post-operatieve wondinfecties.Het is onbekend in welke mate S. aureus neusdragerschapbij zorgverleners bijdraagt aan post-operatievewond infecties. Doel van deze studie was om het percentageS. aureus-neusdragerschap bij een grote groep chirurgenen chirurgen in opleiding in Nederland te beschrijven.Tijdens de Chirurgendagen in mei 2012 werden chirurgen(n = 216) en chirurgen in opleiding (n = 148), 256 mannenen 108 vrouwen, vrijwillig gescreend op S. aureus-neusdragerschap.De controlegroep bestond uit patiënten reguliergescreend op S. aureus-neusdragerschap (n = 1990).De prevalentie van S. aureus-neusdragerschap onderchirurgen (in opleiding) bedroeg 45,1%, hetgeensignificant hoger was dan in onze controlegroep (27,1%,p < 0,001). Mannelijke chirurgen in opleiding (49,4 %)en mannelijke chirurgen met 0-10 jaar ervaring (60,0 %)hadden het hoogste percentage S. aureus-neusdragerschap.De laagste percentages S. aureus-neusdragerschap werdengevonden bij vrouwelijke chirurgen meer dan 10 jaarpraktiserend (25,0 %) en mannelijke chirurgen meer dan20 jaar praktiserend (34,9 %).Concluderend laat deze studie zien dat S. aureus-neusdragerschapin Nederland bij chirurgen (in opleiding) in45,1 % voorkomt, significant hoger dan de controlegroep,met de hoogste percentages bij mannelijke chirurgen met0-10 jaar ervaring en mannelijke chirurgen in opleiding.Ned Tijdschr Med Microbiol 2012;20:nr4185