Medifix

Pigs and Methicillin-Resistant Staphylococcus aureus (MRSA)

Numerous researchers in other countries have been reporting results on the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in pigs and the risk of human contraction.

But recently, researchers with the epidemiology department at the University of Iowa conducted the first test of U.S. swine for MRSA, the bacterium responsible for 94,360 infections and 18,650 deaths in the United States in 2005, a year in which MRSA killed more people than AIDs.

Methicillin-resistant Staphylococcus aureus (MRSA) is a multi-drug-resistant bacterium that is a tremendous problem in people. MRSA was originally a concern mainly in hospitalised individuals but there has been a dramatic increase in community-associated disease (infections in people in the general population) over the past 10 years. MRSA is now a leading cause of skin and soft tissue infections in people in the general population and can also cause severe diseases such as necrotising fasciitis ('flesh-eating disease') and severe pneumonia.

This bacterium is emerging concern in a variety of animal species and a potential problem for the pork industry because of real or perceived public human health risks associated with contact with pigs or pork. While not an important cause of disease in pigs themselves, there is tremendous concern about MRSA because of its role as an important (and high-profile) cause of disease in people.

Concerns about MRSA in pigs came to the forefront a few years ago, with reports from Europe identifying high rates of MRSA carriage in the nose and intestinal tracts of a large percentage of healthy pigs in different countries. This was identified following diagnosis of 'unexpected' cases of MRSA infection in pig producers, swine veterinarians and their families. High rates of MRSA carriage were also found in people that work with pigs, and a Dutch study reported that pig farmers in that country were 760 times more likely to carry MRSA compared to the general population.

One unique aspect was the finding that virtually all pigs (and people associated with pigs) that carried MRSA had one specific strain, called ST398. This strain has historically been very rare in people and it is suspected that it is actually of pig (or pig and cattle) origin.

Since the initial finding of MRSA in pigs, there have been various reports implicating pigs as a source of human infections in Europe, with increasing rates of ST398 MRSA infection. Contact with pigs (or cattle) has been identified as a significant risk factor for MRSA carriage or infection in multiple European studies. The association between pig contact and MRSA is so strong in some regions that pig farmers and veterinarians are automatically isolated if they are admitted to hospital based on the assumption that they are carrying MRSA.

Since the first reports of MRSA in pigs in Europe, there has been considerable interest in this organism internationally. Studies have been performed in various countries evaluating the presence of MRSA in pigs and the possible role of pigs in human MRSA infections. The first study of pigs in North America identified MRSA carriage in 20% of healthy pigs on a sample of Ontario farms. 25 per cent of producers were also carrying MRSA, and in every instance where MRSA was found in a producer, the same strain was found in one or more pigs on the farm. This was followed by a report of MRSA in pigs in Iowa and it is likely that MRSA is widely distributed in pigs throughout North America.

Currently, studies are ongoing to evaluate the prevalence of MRSA carriage by pigs across Canada. Results should be available in early to mid-2009.

Not surprising, the finding of MRSA in pigs led to concerns about food as a source of infection, either through ingestion of MRSA or from people inoculating themselves, i.e. their nose or wounds, with MRSA from meat. A preliminary European study found MRSA in a small percentage of retail pork samples.

According to a study published in the June issue of Clinical Microbiology and Infection, "Screening of pig farmers and pigs in The Netherlands has revealed that >20% of pig farmers and 39% of slaughterhouse pigs are positive for an unusual strain of methicillin-resistant Staphylococcus aureus (MRSA) belonging to sequence type (ST) 398. It is now clear that the emergence of ST398 is not just a Dutch problem, with human infections being described in several European countries, Canada and Singapore. Furthermore, some human isolates have now acquired the genes encoding Panton-Valentine leukocidin. Livestock may become an important source of community-acquired MRSA. A concerted effort on the part of clinicians, infection control practitioners and veterinarians will be required to prevent further spread of this novel strain of MRSA."

At least three people in Scotland are known to have contracted the ST398 strain, and experts are speculating that they probably contracted it from handling or eating meat. MRSA has been found in swine in Denmark, Belgium, the Netherlands and Germany and in other farm animals such as chickens and cattle. The strain –- which has caused skin infections and rare heart and bone problems in humans –- is believed to have spread among pigs.

"The recent wave of MRSA-related illnesses and deaths among otherwise healthy students and athletes is very troubling. We need to determine as soon as possible whether some of those illnesses and deaths are traceable to the overuse of antibiotics on swine farms," said Margaret Mellon, director of Union of Concerned Scientist's Food and Environment Program in a prepared statement.

Of the 200 pigs tested in the Ohio study, 70 percent carried a strain of MRSA, ST398, which is known to affect humans. The researchers, led by Tara Smith, an assistant professor at the University of Iowa College of Public Health (and blogger at Aetiology), led the research team that found almost half of 20 workers on local pig farms carried the same strain of MRSA,

Family Pets May Harbor MRSA, Other Nasties

New Research Points to Dogs, Cats are Carriers of the Deadly Superbug; June 22, 2009

The nasty, drug-resistant bacteria known as MRSA may have a new carrier: the family pet. The scourge of hospital wards and locker rooms, MRSA often begins with small red bumps that can turn into painful abscesses requiring surgery to drain them.

For a small number of unfortunate pet owners, household cats and dogs can be a source of infection with the superbug MRSA. If not detected and treated, they can find their way into the body, causing infections in heart valves, lungs, joints, bones and the bloodstream.

Yes, Kitty and Spot may be boon companions, but their friendship comes with the possibility of the transmission of methicillin-resistant Staphylococcus aureus and at least 30 other pathogens, according to Dr. Richard Oehler and his colleagues at the University of South Florida College of Medicine in Tampa.

Many of these bugs are transmitted by bites and scratches, but others -- such as MRSA -- can cycle back and forth between pets and owners, Oehler and his colleagues warned in a review article, which appears in the July edition of the journal Lancet Infectious Diseases.

"Pet owners are often unaware of the potential for transmission of life-threatening pathogens from their canine and feline companions," the researchers said.

A growing body of evidence that cats and dogs can be colonized by MRSA -- germs that are probably acquired from their owners, since cats and dogs usually carry a different strain of Staphylococcus bacteria.

But the cats and dogs can give the bug back. As long ago as 1988, researchers reported that a cat living in a United Kingdom geriatric unit had passed MRSA back to people. Screening of patients and staff showed that 38 percent of the nursing staff there had colonies of the bacteria living somewhere on them.

And that's not uncommon, according to Lawrence McGill, a veterinarian at the ARUP Animal Reference Pathology Laboratory in Salt Lake City, Utah. "There is more and more data pointing to the [fact that the] most common source for animal infections with MRSA is from humans, including contact with medical facilities where humans are treated," McGill said.

In 2006, researchers isolated MRSA from the skin sores of a three-year-old domestic short-haired cat and -- for the first time in a household pet -- confirmed the pathogen as belonging to the infamous strain known as USA300.

The USA300 clone is a major source of skin infection in community-acquired MRSA in the United States -- and the owner of the cat had indeed experienced repeated soft-tissue staphylococcal infections.

PS: School children coming in contact with carriers of these bacteria (colonized in the nose and hands) can result in serious MRSA infections. List of families with pets like dogs and cats must be maintained in school. They must be regularly monitored and if necessary must be advices to get routine nasal swab checked.

Chicken Flocks Harbor Superbug: February 10, 2009,

Add chickens to the list of farm animals that are harboring MRSA, or methicillin-resistant

Staphylococcus aureus, a formerly rare bacteria found mostly in hospitals but now spreading far and wide.

More than 90,000 people become ill and 18,000 die each year from MRSA infections in the U.S., by one recent estimate. There's growing evidence that industrial-scale livestock operations may help sustain the bacteria and expose people to infection.

MRSA bacteria showed up in broiler chickens at two out of 14 farms tested in Belgium, according to an upcoming report in Emerging Infectious Diseases.

The bacterial strain matched one previously found widely in pigs in the U.S., Canada, Denmark and the Netherlands. Tests in the chicken study showed the staph bacteria could defend itself from seven kinds of antibiotic.

While there's no official reports of MRSA in U.S. chicken flocks, the bacteria has gained a foothold at hog-raising farms in this country. Researchers in Iowa found MRSA in 49 percent of 299 pigs tested at two large-scale pork producers. The bacteria also showed up in nine of 14 workers tested at one of the sites, researchers reported last month in the journal

None of the workers became ill, but the strain has caused human infections in The Netherlands -- justifying concerns that livestock could serve as a reservoir for spreading illness among people.

Livestock growers routinely feed a variety of antibiotics to hogs, cattle and poultry to boost growth. Studies have found that the practice can promote the rise of drug-resistant bacterial strains. The European Union banned the use of antibiotics as growth promoters three years ago, and the U.S. was set to follow suit, but the Food and Drug Administration made a last-minute reversal in December which allows the continued use of cephalosporin antibiotics in food-producing animals.

Methicillin-resistant Staphylococcus aureus (MRSA)strains belongingto clonal lineage sequence type (ST) 398 are being reportedat an increasing frequency in Europe.¹ This new MRSA type hasbeen isolated from colonized and infected animals and humans,and also from meat in some countries,^1,2 representing a riskto human health; nevertheless, so far, no data about detectionof MRSA ST398 in food in Spain have been published.

Children living in farms, having pigs and chicken at home must be isolated if they are found to have skin rashes. These bacteria can seriously infect children on steroids treatment for asthma, eczema or when immune suppressed. Secondary bacterial (MRSA) infection is common in children with swine flu or other virus infections.

Your own health at risk Using Antibiotics 14 Dec 2009

Many people believe that intensive animal production cannot go without the use of antibiotics. To a certain level they may be right, since various producers consider its use as harmless and profitable. Sometimes the use is part of the standard feed, while there is no immediate bird health issue involved. Preventive antibiotic use is then the excuse.

For a long time this was accepted, but the situation changed when the first rumours about bacterial resistance made headlines in the public news media. Many producers, though, ignore the worries expressed by public health officers and consumer representatives. They probably believed that it was all hype and would fade away over time. Reality, however, is different. Antibiotic resistance is real and it caused serious public health issues. It affects consumers as well as producers.

The most serious problem is the Methicillin-resistant Staphylococcus aureus (MRSA). This is a bacterium responsible for several infections that are difficult to treat in humans. It has adapted to survive treatment with beta-lactam antibiotics, which is especially troublesome in hospital-associated infections. Although the issue regarding resistance was originally not seen as being related to animal production, it now definitely is. In case of hospitalisation, livestock producers are registered as such and may be taken into isolation. They are seen to be a special threat and possible carriers of multi-resistant bacteria. In case of an infection with such a bacterium the patient will suffer from problems that are difficult to treat, if a treatment is even available.

With this knowledge, livestock producers must understand this is not without risk for the health of himself, his family, friends as well as his staff. He also remains responsible for the quality and safety of the food products he delivers to the market or feeds his family. Consumers are becoming more and more aware of the risk of antibiotic use in meat and egg production and may decide to not buy products that are believe to be risky.

Although most of the time MRSA is linked to pig production, it is also related to the veal and poultry industry. The industry, therefore, cannot shrug its shoulders and move on if nothing was wrong. _________________________________________________________________________

Resistance To Dis-infectants; ScienceDaily (Dec. 27, 2009)

Using disinfectants could cause bacteria to become resistant to antibiotics as well as the disinfectant itself, according to research published in the January issue of Microbiology. The findings could have important implications for how the spread of infection is managed in hospital settings.

Researchers from the National University of Ireland in Galway found that by adding increasing amounts of disinfectant to laboratory cultures of the bacteria could adapt to survive not only the disinfectant but also ciprofloxacin - a commonly-prescribed antibiotic - even without being exposed to it. The researchers showed that the bacteria had adapted to more efficiently pump out antimicrobial agents (disinfectant and antibiotic) from the bacterial cell. The adapted bacteria also had a mutation in their DNA that allowed them to resist ciprofloxacin-type antibiotics specifically.

Disinfectants are used to kill bacteria on surfaces to prevent their spread. If the bacteria manage to survive and go on to infect patients, antibiotics are used to treat them. Bacteria that can resist both these control points may be a serious threat to hospital patients.

Importantly, the study showed that when very small non-lethal amounts of disinfectant were added to the bacteria in culture, the adapted bacteria were more likely to survive compared to the non-adapted bacteria. Dr. Gerard Fleming, who led the study, said, "In principle this means that residue from incorrectly diluted disinfectants left on hospital surfaces could promote the growth of antibiotic-resistant bacteria. What is more worrying is that bacteria seem to be able to adapt to resist antibiotics without even being exposed to them."

Dr. Fleming also stressed the importance of studying the environmental factors that might promote antibiotic resistance. "We need to investigate the effects of using more than one type of disinfectant on promoting antibiotic-resistant strains. This will increase the effectiveness of both our first and second lines of defence against hospital-acquired infections," he said.

The first case of highly drug resistant TB has been confirmed in the United States. The victim, 19 year old Oswaldo Juarez, has been quarantined in a Florida TB sanatorium. Health officials have long dreaded the possibility of a drug resistant strain of tuberculosis because of the extremely contagious nature of traditional TB. Every time a TB patient coughs, they spread the risk of contracting this deadly germ to everyone around them.

No one knows how many fatalities are caused by these superbugs every year because doctors don't want to believe nor accept this as a major threat to mankind. Theses bugs are "Killers", there is "No Cure" no matter who tells what because I have seen healthy children die within 24 hours. It was easier for me to manage a child dying after drowning or an accident because parents could accept the consequence but distressing for me to tell a mother "I have no cure this simple infection

Your best defence against them is to stop creating them in your own environment and helping to spread them in your family, friends & schools.

Do not use antibiotics for viral infections.

Most sniffles, runny noses, ear aches and colds are viral. Antibiotics are not an effective defence against any virus. If you go to the doctor with a cold, or flu-like symptoms, make sure you test positive for bacteria before you accept a prescription for antibiotics.

1. Use antibiotics as directed. If you are prescribed antibiotics, take them exactly as prescribed. Finish the entire prescription. Do not share the pills with friends or family members. Do not stop taking them until they are gone.

2. Limit the use of household antibacterial products. These products were designed to use when someone in the home has a contagious bacterial infection. They work the same way as antibiotics. When these products are used for everyday cleaning, you run the substantial risk of causing naturally occurring bacteria to mutate into a deadly strain. Use antibacterial products only when someone is suffering from a bacterial infection.

3. Use plenty of regular soap and hot water. Stop trying to kill all the germs in your home. It simply is not possible. Cleaning with regular soap and hot water is highly effective and does not kill off the normal bacteria that exists everywhere. Therefore, it does not force the benign bacteria to mutate into something that can kill you.

4. Educate your school officials. In an attempt to try to control contagious disease, many school have resorted to using antibacterial hand cleaners. This is not only ineffective, but dangerous. Each child brings normally benign bacteria to school with them. When these bacteria are attacked, they may not all be destroyed. If they are not totally eradicated, they will mutate to overcome the threat. If they mutate, they can become a deadly threat to your children and you.

5. Tell your friends and family about the risks of antibiotic, antiseptics, detergents and antibacterial hand wash overuse. Make sure everyone you know understands exactly how dangerous these products can be when they are used for anything other than what they were designed for.