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Prevalensen av Meticillinresistent Staphylococcus aureus CC/ST398 i länder som Sverige importerar mest kött ifrån och risk för spridning till Sverige.
Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
2019 (Swedish)Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
Abstract [en]

Background: MRSA or Methicillin-resistant Staphylococcus aureus consists of several strains in the bacterial species called Staphylococcus aureus. MRSA is resistant to methicillin but also to other types of antibiotics. Spread can occur both directly between humans and between humans and animals, but also indirectly through air.

The number of positive bacterial cultures for MRSA in Sweden increases every year. The prevalence of MRSA of different types varies in different countries. LA-MRSA is a livestock-associated methicillin-resistant Staphylococcus aureus that was first discovered in the Netherlands in pigs. This bacterial type belongs to a specific clone called CC398 (clonal complex 398), were most belonged to a specific sequence type called ST398 (multi locus sequence type 398). The CC398 strain are constantly acquiring new features including virulence factors such as the PVL-gene has been reported and associated with serious infections in humans and animals. This specific bacterial clone is found primarily in food producing animals around Europe, and it can infect humans and cause infection. It occurs mainly in pigs and can be spread through contaminated pork or other meat products to humans.

Purpose: This work was aimed to survey the prevalence of LA-MRSA in the countries from which Sweden imports most meat from and to review the spread from meat products.

Method: This study is been based on information on antibiotic use among food producing animals and the proportion of reported cases of MRSA in the countries from which meat was imported. Scientific studies in all countries was used to obtain information on the prevalence of MRSA CC/ST 398 and on its characteristics.

Results: The countries from which Sweden imports most meat are Germany, Denmark and the Netherlands, pork import dominates. In 2018 there were 27,260 tonnes of pork imported from Denmark and 45,197 tonnes from Germany, compared with imports from the Netherlands, which amounted to 6,888 tonnes. Germany has the highest antibiotic consumption and the highest proportion of reported cases of MRSA among these countries.

In Denmark, the CC/ST 398-clone caused 17 blood infections and 700 skin and soft tissue infections between 2010 and 2015. In Germany, 166 of 330 pigs examined in 2012 were positive for the same clone, as was 77 of the 134 collected samples from the environment and 39 of the 63 animal caretakers. In Brazil, CC / ST398 was found in 6 of 1852 children, genotypic characterization indicated it was an MSSA (methicillin-sensitive S. aureus) CC398 that had acquired SCCmec genes in the health care system. In Italy 81 of 215 pig isolates collected were positive for MRSA where the dominant type was CC / ST398. Virulence genes associated with human MRSA strains such as enterotoxin and PVL genes were not present among the pig isolates. Resistance to tetracycline was seen in all pig isolates. In the Netherlands, MRSA CC / ST398 was linked to pigs in that sense that the humans that were infected were exposed to pigs on a daily basis.

Conclusion: The prevalence of LA-MRSA CC / ST398 was high in all the countries surveyed. Resistance to tetracyclines was significantly higher among pig isolates compared to HA-MRSA isolates (healthcare-associated MRSA), whereas the virulence genes such as the PVL- gene usually not present detected in pig- isolates. Among strains identified as LA-MRSA CC / ST398 acquired SCCmec-genes were of types V and IV.  The spread from pigs or meat was through direct contact but also through air.

Place, publisher, year, edition, pages
2019. , p. 28
Keywords [sv]
LA-MRSA, HA-MRSA, Klonalkomplex CC398, multilocussekvenstyp ST398
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:lnu:diva-90372OAI: oai:DiVA.org:lnu-90372DiVA, id: diva2:1375301
Educational program
Bachelor of Science Programme in Pharmacy, 180 credits
Supervisors
Examiners
Available from: 2019-12-05 Created: 2019-12-04 Last updated: 2019-12-05Bibliographically approved

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