First isolation of mrsa st398 from uk animals: a new challenge for infection control teams?

Journal of Hospital Infection (2009) 72, 1e2 Available online at First isolation of MRSA ST398 from UK animals: the six months prior to MRSA isolation and had a new challenge for infection control teams? Second, an 11-year-old Andalusian gelding was imported from Spain nine months previously andMRSA ST398 was isolated from a clinical sample of As the control of meticillin-resistant Staphylococ- a postoperative wound. The horse had undergone cus aureus (MRSA) remains a major challenge for exploratory laparotomy four weeks earlier and had UK hospitals, community healthcare facilities and received postoperative antimicrobial therapy with the veterinary profession, we wish to report the gentamicin and penicillin. Subsequently the horse first isolation of MRSA sequence type 398 from had been given trimethoprim/sulfamethoxazole em- pirically when signs of a surgical site infection were MRSA strains isolated from dogs and cats are typically healthcare-associated strains, and, in the Both MRSA isolates were confirmed genetically UK, belong to lineages represented by EMRSA-15 by thermonuclease gene (nuc) and mecA PCR. They and EMRSA-16 (ST22 and ST36 respectively). In were non-typeable by pulsed-field gel electro- contrast, this new MRSA lineage ST398 emerged in phoresis following SmaI digestion, were negative a pig-reservoir in The Netherlands in 2004. It has on toxin gene profiling (including PantoneValentine subsequently been identified in Canada and Singa- leucocidin), spa type t011 and carried SCCmec pore, but in Europe remained confined to the IVa.Both were resistant to penicillin, amoxicillin, continent until recently. MRSA ST398 can spread cefalexin, tetracycline and gentamicin by disc rapidly among pig herds. It can also affect people diffusion following Clinical and Laboratory Stan- and is proving an unexpected challenge for Dutch dards Institute guidelines but susceptible to enro- hospital infection control teaHowever, its floxacin. The second isolate was also susceptible typical link with pigs and certain genetic charac- teristics provide an excellent opportunity for early The phenotypic and genotypic characteristics of recognition and control which may help to prevent these equine UK isolates match those reported from an additional burden for the healthcare sector.
horses in Belgium, Austria and Germany which also Here we summarise the isolation of MRSA ST398 carry SCCmec IVThey vary from those commonly from two horses in southeastern England.
found in pigs which are of spa types t108, t034 or An 11-year-old thoroughbred mare was enrolled t571 and often carry SCCmec V, possibly indicating in a screening study for MRSA carriage on admission host-specific variation within this lineage or inde- to the Royal Veterinary College (RVC) Equine Re- pendent evolution. Interestingly, isolates from pigs ferral Hospital. MRSA ST398 was isolated from and horses commonly show resistance to tetracy- a pooled sample of nasal, oral, axillary and cline and/or gentamicin, both agents frequently perianal carrier sites processed after selective used in pigs and horses respectively.
enrichment as described previously.The horse To date, there has been only a single report of had been referred to the hospital with sudden- MRSA ST398 in the UK. It involved three infants in onset lameness associated with cellulitis and syno- Scotland in 2007 without an epidemiological link to vitis. Antimicrobial therapy with gentamicin and These isolates were less resistant and geno- penicillin had been initiated by the referring veter- typically different (spa t034 and SCCmec III) from inary surgeon w6 h earlier. The affected limb was not sampled for bacterial culture and a follow-up As the second horse had been shipped overland swab from carrier sites was not available. The stopping in France for one night en route, a direct horse had not received veterinary treatment in vector-transmission of MRSA ST398 to the UK is 0195-6701/$ - see front matter ª 2009 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.
doi:10.1016/j.jhin.2009.04.002 Please cite this article in press as: Loeffler A et al., First isolation of MRSA ST398 from UK animals: a new challenge for infectioncontrol teams? J Hosp Infect (2009), doi:10.1016/j.jhin.2009.04.002 plausible. ST398 has been reported from France 2. Loeffler A, Boag AK, Sung J, et al. Prevalence of methicillin- resistant Staphylococcus aureus among staff and pets ina small animal referral hospital in the UK. J Antimicrob epidemiological connection to countries where ST398 is prevalent could not be established. The ¸o C, Oliveira DC, de Lencastre H. Multiplex PCR finding of identical spa and SCCmec types among strategy for subtyping the staphylococcal cassette chromo- the two isolates suggests that either (i) this strain some mec type IV in methicillin-resistant Staphylococcus au- has a predilection for horses, or (ii) a connection reus: ‘SCC mec IV multiplex’. J Antimicrob Chemother 2007;60:42 between the two horses. Such a connection via 4. Holmes A, Ganner M, McGuane S, Pitt TL, Cookson BD, staff or laboratory facilities cannot be excluded Kearns AM. Staphylococcus aureus isolates carrying Pan- but sampling and isolation were performed by dif- toneValentine leucocidin genes in England and Wales: fre- ferent members of RVC staff. Screening of a total quency, characterization, and association with clinical of 151 horses for MRSA carriage during the 6 month disease. J Clin Microbiol 2005;43:2384e2390.
5. Van den Eede A, Martens A, Lipinska U, et al. High study period yielded no further MRSA ST398.
occurrence of methicillin-resistant Staphylococcus aureus Animal reservoirs for MRSA are becoming recog- ST398 in equine nasal samples. Vet Microbiol 2009;133: nised around the world with increasing awareness of MRSA ST398 colonising pig and veal farmers, and 6. Edwards G, Cosgrove B, Girvan K. ST398 MRSA infection in attending vets, at high rates.In The Netherlands, Scotland e no pig association apparent. International Sympo-sium on Staphylococci and Staphylococcal Infections 2008, these groups are now considered high risk and, if ad- mitted to hospital, are immediately targeted for iso- 7. Armand-Lefevre L, Ruimy R, Andremont A. Clonal compari- son of Staphylococcus aureus isolates from healthy pig These findings herald the introduction of ST398 farmers, human controls, and pigs. Emerg Infect Dis 2005; into England and give further evidence of the 8. Van Rijen MM, van Keulen PH, Kluytmans JA. Increase in successful spread of this zoonotic pathogen within a Dutch hospital of methicillin-resistant Staphylococcus au- the animal reservoir. However, awareness will also reus related to animal farming. Clin Infect Dis 2008;46: provide new opportunities for control strategies.
We recommend vigilance for MRSA ST398 in bothanimals and humans in the UK.
We thank the Royal Veterinary College diagnostic laboratory team for their good collaboration.
Department of Veterinary Clinical Sciences, The carriage isolate was identified as part of Royal Veterinary College, Hawkshead Lane, a large UK screening project on MRSA carriage in companion animals funded by the PetPlan Char- Staphylococcus Reference Unit, Centre for Centre for Infection, Department of Cellular and 1. Voss A, Loeffen F, Bakker J, Klaassen C, Wulf M. Methicillin- resistant Staphylococcus aureus in pig farming. Emerg Infect * Corresponding author. Address: Department of Veterinary Clinical Sciences, Royal Veterinary College, Hawkshead Lane,Hatfield, North Mymms, Hertfordshire AL9 7TA, UK. Tel.: þ441707 666246; fax: þ44 1707 666298.
Please cite this article in press as: Loeffler A et al., First isolation of MRSA ST398 from UK animals: a new challenge for infectioncontrol teams? J Hosp Infect (2009), doi:10.1016/j.jhin.2009.04.002


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