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Methicillin Resistant Staphylococcus aureus (MRSA) Linkage to
Swine Farms Felicia
Lamb September
27, 2010 Abstract Antibiotics
have been used in animal livestock production systems for decades in the
treatment and/or prevention of disease associated with high density confinement
systems. The methodology most often applied is to administer subtherapeutic
doses of the same antibiotics used in human medicine through the daily ration
fed to the animals. (Tilman,
et al. 2002). The goal of this practice is increased efficiency resulting
in larger food production capabilities. According to it Ferber (2010) pigs and
other livestock commonly harbor S. aureus
with no adverse symptoms. Recently however a strain of Methicillin Resistant Staphylococcus aureus (MRSA) tagged ST
398 was isolated from three Dutch swine operations after appearing in three
human cases in the Netherlands (Ferber, 2010). Prior to this time, MRSA was
rare in this region of the globe according to Ferber (2010). Of concern is the
knowledge that MRSA can move across species from livestock to humans, although
ST398 has not been formerly shown to be transmittable between humans which
lowers the chance of broad community epidemic scenarios (Ferber, 2010). Introduction In
the mid 1900s the Methacillin Resistant Staphylococcus
aureus (MRSA) was first isolated in Europe and has been a leading cause of
infection in hospitals. In livestock the bacteria is carried in the nose or
snout of the animal. Up until recently MRSA in livestock was not a great
concern however, that changed when it was discovered that a unique strain of
MRSA is able to move from animals to humans. This discovery has led to further
pressure from consumer and public health groups (Bottemiller, 2010) upon
federal agencies such as the U. S. Food and Drug Administration to ban the
routine or nontherapeutic use of antibiotics in food-producing animals. This
proposal will outline the procedure in which a literature review of the
potential impact of MRSA ST 398 on human health will be conducted..” Background A new strain of methicillin resistant Staphyllococcus aureus (MRSA) has the capability of jumping from
livestock to humans. MRSA has reached epidemic proportions; today 20% of the
bloodstream infections in hospitals are directly related to S. aureus, and 65% of the S. aureus infections in the ICU resist
methicillin (Ferber, 2010). The Center for Disease Control cited greater than
18,000 deaths in 2005 (Ferber, 2010). During a routine pre-operative exam by a physician in the
Netherlands it was discovered that a young patient had MRSA, which is
considered rare in the Dutch population. Further investigation linked two other
similar cases to hog production/confinement operations. Agricultural practices
of prophylactic antibiotic use to prevent disease outbreak and enhance growth
have been widely criticized (Ferber, 2010; Bottemiller, H 2010; McKenna, M.
2009; Tilman et al 2002)). These pressures have led to a proposal by the U.S.
Food and Drug Administration to phase out this potentially dangerous use of
antibiotics in the livestock food supply for human consumption (Bottemiller, H.
2010). The MRSA strain associated with pig farming is now called ST398. A further
study (McKenna, 2009) revealed that cattle farmers were also at risk of
contracting this strain of MRSA from their herds. Case reports of ST398 include soft tissue infection,
mastitis, severe wound infections, pneumonia, and flesh eating disease.
Thankfully, ST398 does not appear to be contagious between humans. However, the
new strain does appear to be spreading across North America as indicated by a report from Iowa
State University, Ames, that documented one hog farm as having 45% of its
workers carrying the MRSA ST398 microbe in their noses (McKenna, 2009). Since MRSA can readily adapt to new conditions in a
potentially virulent manner, veterinary microbiologist Gal Hansen of the Pewe
Health Group in Washington, DC urges extreme caution and vigilant monitoring of
ST398 to prevent an unexpected outbreak of concerning proportion ( McKenna,
2009). Project The
focus of this project will be to develop a literature review that will include
scienctific journals, U. S. Department of Health and Human Services statistical
reports, U.S. Food and Drug Adminsitration policy records, and daily news commentary
involved with the issue of MRSA in the United States and beyond. Particular
emphasis will be given to the recent developments surrounding ST 398. Other sources of data may include
research from the Sanford Health CCU care nurses. I chose this topic because of my extensive patient care with
MRSA infected individuals, and its immediate relevance to the recovery of
cardiac patients and other post operative or immune compromised patients,
providing a localized analysis to serve as a sample population for the state of
North Dakota. Health professions are the ones working closest with this
infection as they are diagnosing and treating it, so they will be the target
audience for the findings of this literature review. The literature review for
this report will include articles published in the last ten years and will be
applied appropriately to the introduction, discussion and conclusion sections
of the paper. Method The
literature search will be conducted from the NDSU library using the vast
database available to students and faculty/staff. Journal holding of the
university library are nearly limitless and include a vast e-journal search
engine as well as inter-library loan. Examples of journals that I will conduct
subject searches in are the following:
Science, The Journal of
Antibiotics, and The American Journal
of Infectious Diseases.
Databases such as Ebsco, Elsevier and Journals.ASM.org have materials
that can be accessed through the college library that I will access as well.
Keywords such as “MRSA”, “Pigs and Infections”, “Swine and MRSA”, “Food Source
and MRSA”, and “treatment MRSA” will be used in the search engines. Another
good source for searching the pool of research on a specific subject is Google
Scholar. I like to go there, find
the articles, and then do the search for the journal in the NDSU e-journal
database. The
data will be compiled into a timeline with major events/issues in the
development MRSA, and progression of treatment with successes and misfortunes,
current treatment in the United State hospitals, and future implications of
long term antibiotic use in the livestock industry. As stated earlier this data
will be pulled not only from scientific review journal articles, but also
relevant magazine articles which will be chosen at my discretion. Schedule Research
has already begun since September 17th, 2010 and will be ongoing
until project completion December 3rd, 2010. Initially, this review
began as a recommendation to read an article in Science. This article
sparked my interest in furthering my knowledge on the topic, which has been
ongoing since the start date. My literature review has three major themes which
are (1) the incidence of MRSA within the past ten years, (2) the policies that
the U. S. federal government is considering with regard to food and drug
safety, and (3) the policies of the Department of Agriculture with regard to
the new strain of MRSA ST398 in confinement livestock operations. I plan to use
peer reviewed scientific articles from journals such as Science, The Journal of Antibiotics, and The American Journal of Infectious Diseases and others found
during the research period to expand
on my knowledge base and to create
applicable questions to pose to nurses in practice. Since MRSA has growing relevance in American Hospitals
today, I will have ongoing contact (October 8th 9th 25th
and 26th) with the nurses at Sanford Health CCU on their
perspectives of the impact MRSA has on recovering cardiac surgery
patients. After data is collected
(by October 29th) an annotated bibliography will be submitted and
the information will be compiled (during November) and put into an APA
formatted literature review by November 24th with a final review
following and the final project completed by December 3rd. Conclusion MRSA
was first discovered in Europe on pig farms, and more specifically in the
snouts of pigs. This was not a
concern till this bacteria was found to spread confluently among livestock and
humans, causing very different effects. This is a proposal to do an overall literature review
of known knowledge of MRSA and new ways of treating MRSA and compiling the data
together to have a better idea of how to educate the public on avoiding
infection and how to better treat it if one does become infected. References Bottemiller, H. (2010). Debate over
antibiotic use continues. Retrieved September 30, 2010, from http://www.foodsafetynews.com/2010/04/debate-over-anitbiotics-in-animal-ag/continues/
Ferber, D., (2010). From pigs to people:
The emergence of a new superbug. Science,
329 (5995), 1010-1011. Gorback, S.L. (2001). Antimicrobial use in
animal feed—time to stop. New
England Journal of Medicine, 345, 1202-1203. McKenna, M., (2009). A new strain of
drug-resistant staph infection found in U.S. pigs. Scientific American. September 25, 2010. Retrieved September 30,
2010 from http://www.scientificamerican.com/article.cfm?id=new-drug-resistant-mrsa-in-pigs Tilman, D., Cassman, K.G., Matson, P. A.,
Naylor, R., & Polasky, S. (2002). Agricultural sustainability and intensive
production practices. Nature, 418,
671-677. |