Saturday, 10 July 2010

MRSA st398 in pigs, people - and now dogs

Published just over a week ago, this from Canada's top expert in zoonotic disease deserves much wider publicity beyond the secretive world of veterinarians, especially in Britain.

MRSA st398 is obviously now moving between pigs, people including a pig vet, and dogs.

Things get worse for Britain's government and pig vets by the minute. That's what you get for covering up and spreading pig disease dangerous to humans for a decade: exposure, investigation and disgrace.

Scott Weese is an Associate Professor in the Department of Pathobiology at the University of Guelph, and Public Health and Zoonotic Disease microbiologist for the University's Centre for Public Health and Zoonoses.

Livestock-associated MRSA in dogs

Posted on June 30, 2010 by Scott Weese

A study we just published in the journal Veterinary Record (Floras et al, 2010) described an MRSA outbreak in a dog breeding kennel. That's a little unusual in itself, but considering how MRSA is spreading amongst the dog population, it's not really astounding. What was unique about this outbreak was the strain that was involved, sequence type 398 (ST398).

ST398 MRSA is commonly referred to as livestock-associated MRSA, since this strain seems to have originated in pigs, and is commonly found in pigs and calves in some regions. It can also infect people, and high rates of carriage of this MRSA strain can be found in pig farmers, pig vets and other people with close contact with livestock. In some areas of Europe, this strain is a big problem, accounting for a large percentage of human infections. Interestingly, it seems to be a rare cause of illness in people in North America (at least at the moment).

Dogs seem to be innocent bystanders when it comes to MRSA. The vast majority of MRSA strains found in dogs are common human strains, indicating that, ultimately, MRSA in dogs originated in people. There are only two other reports of dogs with ST398, both from Europe. One was a dog with a skin infection. The other was a healthy dog (a carrier) who was owned by a pig vet.

This outbreak involved a larger number of dogs, with both healthy carriers and sick dogs. Overall, MRSA was isolated on one or more occasion from 23/42 (55%) of dogs in the kennel. In a couple litters, most puppies were identified as carriers, but fortunately most stayed healthy. MRSA did cause skin infection in a puppy and mastitis in a mother dog, and was also found in the respiratory tract of a puppy that died (although it may or may not have been the cause of death).

The source of the ST398 was not identified. One of the owners worked on a pig farm, but MRSA was not isolated from either owner. It's most likely that the owner did bring MRSA home from the farm, either as a transient carrier (in their nose) or as a contaminant on their skin. Regardless, once it got into the kennel, it was able to move between dogs, either from dog-dog contact or with the help of human hands. Fortunately, ST398 MRSA carriage by dogs seemed to be transient, consistent with what we know about carriage of other strains. MRSA is not really adapted for longterm survival in a dog, so they only carry it for short periods of time. That's a big advantage when it comes to trying to control this bug.

While we have to be careful and not overinterpret data from only a few studies, this report indicates that ST398 can cause disease in dogs and be present in apparently healthy dogs. It can also be spread widely in a breeding kennel situation. While a pig-link was not confirmed, it's reasonable to suspect that dogs with contact with pigs(and perhaps other livestock) might be at higher risk of developing ST398 infections, as is the case with people.

This is a perfect example of the one medicine concept, and why we need to think about infectious diseases in broad terms, not just focusing on specific populations. This situation involved a pig Staphylococcus aureus that somehow acquired methicillin-resistance, spread widely around the world (most likely in pigs, initially), spread to people, and then likely spread to other species like dogs.