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首页> 外文期刊>Environmental research >Swine exposure and methicillin-resistant Staphylococcus aureus infection among hospitalized patients with skin and soft tissue infections in Illinois: A ZIP code-level analysis
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Swine exposure and methicillin-resistant Staphylococcus aureus infection among hospitalized patients with skin and soft tissue infections in Illinois: A ZIP code-level analysis

机译：伊利诺伊州皮肤和软组织感染住院患者中的猪暴露和耐甲氧西林金黄色葡萄球菌感染：邮政编码级别分析

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Background: Methicillin-resistant Staphylococcus aureus (MRSA), a bacterial pathogen, is a predominant cause of skin and soft tissue infections (SSTI) in the United States. Swine-production facilities have been recognized as potential environmental reservoirs of MRSA. To better understand how swine production may contribute to MRSA infection, we evaluated the association between MRSA infection among SSTI inpatients and exposure measures derived from national swine inventory data. Methods: Based on adjusted odds ratios from logistic regression models, we evaluated the association between swine exposure metrics and MRSA infections among all Illinois inpatient hospitalizations for SSTI from January 2008 through July 2011. We also assessed if swine exposures had greater association with suspected community-onset MRSA (CO-MRSA) compared to suspected hospital-onset MRSA (HO-MRSA). Exposures were estimated using the Farm Location and Agricultural Production Simulator, generating the number of farms with greater than 1000 swine per residential ZIP code and the residential ZIP code-level swine density (swine/km~2). Results: For every increase in 100 swine Am2 within a residential ZIP code, the adjusted OR (aOR) for MRSA infection was 1.36 (95% CI: 1.28-1.45). For every additional large farm (i.e., > 1000 swine) per ZIP code, the aOR for MRSA infection was 1.06 (95% CI: 1.04 -1.07). The aOR for ZIP codes with any large farms compared to those with no large farms was 1.24 (95% CI: 1.19 - 1.29). We saw no evidence of an increased association for CO-MRSA compared to HO-MRSA with either continuous exposure metric (aORs = 0.99), and observed inconsistent results across exposure categories. Conclusions: These publicly-available, ecological exposure data demonstrated positive associations between swine exposure measures and individual-level MRSA infections among SSTI inpatients. Though it is difficult to draw definitive conclusions due to limitations of the data, these findings suggest that the risk of MRSA may increase based on indirect environmental exposure to swine production. Future research can address measurement error related to these data by improving exposure assessment precision, increased specification of MRSA strain, and better characterization of specific environmental exposure pathways.
机译：背景：耐甲氧西林金黄色葡萄球菌（MRSA）是一种细菌病原体，是美国皮肤和软组织感染（SSTI）的主要原因。猪的生产设施被公认为是MRSA的潜在环境资源库。为了更好地了解猪的生产可能如何导致MRSA感染，我们评估了SSTI住院患者的MRSA感染与国家猪存栏数据得出的暴露指标之间的关联。方法：根据Logistic回归模型的校正比值比，我们评估了2008年1月至2011年7月所有伊利诺伊州住院SSTI住院患者的猪暴露指标与MRSA感染之间的关联。与疑似医院发作的MRSA（HO-MRSA）相比，MRSA的发病率更高（CO-MRSA）。使用农场位置和农业生产模拟器估算暴露量，得出每个住宅邮政编码大于1000头猪的农场数量和住宅邮政编码级别的猪密度（猪/ km〜2）。结果：居住区邮政编码内每增加100头猪Am2，MRSA感染的调整后OR（aOR）为1.36（95％CI：1.28-1.45）。对于每个邮政编码，每增加一个大型农场（即> 1000头猪），MRSA感染的aOR为1.06（95％CI：1.04 -1.07）。与没有大型农场的邮政编码相比，任何大型农场的邮政编码的aOR为1.24（95％CI：1.19-1.29）。我们没有证据表明与使用连续暴露指标（aORs = 0.99）的HO-MRSA相比，CO-MRSA的关联性增加，并且观察到不同暴露类别的结果不一致。结论：这些可公开获得的生态暴露数据表明，在SSTI住院患者中，猪暴露措施与个体水平MRSA感染之间存在正相关。尽管由于数据的限制很难得出明确的结论，但这些发现表明，由于猪生产环境的间接暴露，MRSA的风险可能会增加。未来的研究可以通过提高暴露评估精度，增加MRSA菌株的规格以及更好地表征特定环境暴露途径来解决与这些数据相关的测量误差。

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