Livestock-Associated, Antibiotic-Resistant Staphylococcus aureus Nasal Carriage and Recent Skin and Soft Tissue Infection among Industrial Hog Operation Workers

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  • Nadimpalli, Maya
    • Affiliation: Gillings School of Global Public Health, Department of Environmental Sciences and Engineering
  • Stewart, Jill R.
    • Affiliation: Gillings School of Global Public Health, Department of Environmental Sciences and Engineering
  • Pierce, Elizabeth
    • Affiliation: Gillings School of Global Public Health, Department of Environmental Sciences and Engineering
  • Pisanic, Nora
    • Other Affiliation: Department of Environmental Health and Engineering; Johns Hopkins Bloomberg School of Public Health
  • Love, David C.
    • Other Affiliation: Johns Hopkins Center for a Livable Future; Johns Hopkins University
  • Hall, Devon
    • Other Affiliation: Rural Empowerment Association for Community Help
  • Larsen, Jesper
    • Other Affiliation: Microbiology and Infection Control; Statens Serum Institut
  • Carroll, Karen C.
    • Other Affiliation: Division of Medical Microbiology; Johns Hopkins University School of Medicine
  • Tekle, Tsigereda
    • Other Affiliation: Microbiology Laboratory; Johns Hopkins Hospital
  • Perl, Trish M.
    • Other Affiliation: Department of Epidemiology; Johns Hopkins Bloomberg School of Public Health
  • Heaney, Christopher D.
    • Other Affiliation: Department of Epidemiology; Johns Hopkins Bloomberg School of Public Health
Abstract
  • Swine production work is a risk factor for nasal carriage of livestock-associated (LA-) Staphylococcus aureus and also for skin and soft tissue infection (SSTI). However, whether LA-S. aureus nasal carriage is associated with increased risk of SSTI remains unclear. We aimed to examine S. aureus nasal carriage and recent (≤3 months prior to enrollment) SSTI symptoms among industrial hog operation (IHO) workers and their household contacts. IHO workers and their household contacts provided a nasal swab and responded to a questionnaire assessing self-reported personal and occupational exposures and recent SSTI symptoms. Nasal swabs were analyzed for S. aureus, including methicillin-resistant S. aureus (MRSA), multidrug-resistant-S. aureus (MDRSA), absence of scn (livestock association), and spa type. S. aureus with at least one indicator of LA was observed among 19% of 103 IHO workers and 6% of 80 household members. Prevalence of recent SSTI was 6% among IHO workers and 11% among 54 minor household members (0/26 adult household members reported SSTI). Among IHO workers, nasal carriers of MDRSA and scn-negative S. aureus were 8.8 (95% CI: 1.8, 43.9) and 5.1 (95% CI: 1.2, 22.2) times as likely to report recent SSTI as non-carriers, respectively. In one household, both an IHO worker and child reported recent SSTI and carried the same S. aureus spa type (t4976) intranasally. Prevalence of scn-negative S. aureus (PR: 5.0, 95% CI: 1.2, 21.4) was elevated among IHO workers who reported never versus always wearing a face mask at work. Although few SSTI were reported, this study of IHO workers and their household contacts is the first to characterize a relation between nasal carriage of antibiotic-resistant LA-S. aureus and SSTI. The direction and temporality of this relation and IHO workers’ use of face masks to prevent nasal carriage of these bacteria warrant further investigation.
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  • Article
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  • In Copyright
Journal title
  • PloS One
Journal volume
  • 11
Journal issue
  • 11
Page start
  • e0165713
Language
  • English
ISSN
  • 1932-6203

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