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Prevention and control of methicillin-resistant Staphylococcus aureus in equine hospitals in Sweden

Bergström, Karin (2013). Prevention and control of methicillin-resistant Staphylococcus aureus in equine hospitals in Sweden. Diss. (sammanfattning/summary) Skara : Sveriges lantbruksuniv., Acta Universitatis Agriculturae Sueciae, 1652-6880 ; 2013:36
ISBN 978-91-576-7811-9
[Doctoral thesis]

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Methicillin-resistant S. aureus (MRSA) was first described in 1961 and has since
caused nosocomial infections and therapeutic limitations. In Sweden, the first finding
of horses infected with MRSA was in 2008. Nosocomial spread of MRSA among
horses is a hazard for the patients and those in contact with the animals. Therefore,
there is a need to introduce or improve routines for prevention and control of MRSA in
veterinary care. MRSA spa-type t011, CC398 caused an outbreak of surgical site
infections in horses. MRSA CC398 is associated with livestock and has been reported
in horses in Europe. The superficial infections healed without antimicrobial treatment.
Longitudinal sampling of post-infected horses showed that all tested negative by time,
median 143 days. The most sensitive site to test for MRSA carriage was the nostrils,
with a relative sensitivity of 0.91. Due to few sampled cases (n=9) MRSA carriage in
horses needs more study. Transmission of MRSA by horses and humans to the
environment was shown through environmental screening. In total, 10 of 92 samples
were positive. The screening was a useful tool in the implementation of basic hygiene.
Rapid response combined with multidisciplinary collaboration was key in the outbreak
control. This led to an improved infection control (IC) operation. Infection control
procedures used in human health care were mainly applicable, but existing differences
between equine and human settings require adapted solutions. Baseline data on IC
procedures in three equine hospitals was collected. Overall excellent compliance with
dress regulations and personal appearance (no rings or wrist watches, short nails etc.)
was shown. Compliance with hand hygiene procedures was poorer. Purchase data per
patient of hygiene products were useful to indirectly monitor compliance trends over
time. Barriers to compliance were such as inaccessible hygiene products, insufficient
knowledge of procedures and high work load. The knowledge presented in this thesis
on epidemiology and prevention and control of MRSA in equine medicine can be used
in the development and implementation of IC procedures in Swedish equine hospitals.
Supplementary multidisciplinary studies of MRSA carriage in horses, species-specific
factors affecting IC and, implementation and compliance with IC can develop the topic further.

Authors/Creators:Bergström, Karin
Title:Prevention and control of methicillin-resistant Staphylococcus aureus in equine hospitals in Sweden
Alternative abstract:

Studierna i avhandlingen har gett kunskap om MRSA hos hästar och
infektionskontroll på hästsjukhus. Resultaten kan användas för att
vidareutveckla preventiva och kontrollerande åtgärder mot MRSA på
hästsjukhus. Avhandlingen pekar på att olika vetenskapsmetoder behövs för att
forska vidare i ämnet. Bärarskap av MRSA hos hästar behöver utredas
ytterligare, vidare behövs innovation av ytmaterial som fungerar i miljön på
hästsjukhus. Hur vårdhygienrutiner ska introduceras för att få så bra följsamhet
som möjligt är ytterligare ett fält som behöver utforskas.
Underhåll av ett infektionskontrollprogram kräver fortlöpande arbete med revisioner, utbildning och övervakning. Sjukhusledningar måste stötta genom
att tillsätta resurser och genom aktivt engagemang. Införande av infektionsförebyggande och kontrollerande åtgärder är ett självklart ansvar som åligger hästsjukhus då MRSA berör både patientsäkerhet och arbetsmiljö.

Series Name/Journal:Acta Universitatis Agriculturae Sueciae
Year of publishing :13 May 2013
Number of Pages:82
I.Bergström, K., Aspan, A., Landen, A., Johnston, C., & Grönlund- Andersson, U (2012). The first nosocomial outbreak of methicillin-resistant Staphylococcus aureus in horses in Sweden. Acta Veterinaria Scandinavica 54, 11.
II.Bergström, K., Bengtsson, B., Nyman, A., Grönlund Andersson U. (2013). Longitudinal study of horses for carriage of methicillin-resistant Staphylococcus aureus following wound infections. Veterinary Microbiology 163, 388-91
III.Bergström, K., Nyman, G., Widgren, S., Johnston, C., Grönlund- Andersson, U. & Ransjö, U. (2012) Infection prevention and control interventions in the first outbreak of methicillin-resistant Staphylococcus aureus infections in an equine hospital in Sweden. Acta Veterinaria Scandinavica 54, 14.
IV.Bergström K. & Grönlund Andersson U. Pre- and post-intervention study of infection control operations in equine hospitals in Sweden (manuscript)
Place of Publication:Skara
Publisher:Institutionen för husdjurens miljö och hälsa, Sveriges lantbruksuniversitet
Associated Programs and Other Stakeholders:SVA - National Veterinary Institute > A contributor is enlisted in SVA
SLU - Research Areas for the Future > Future Animal Health and Welfare (until Jan 2017)
ISBN for printed version:978-91-576-7811-9
Publication Type:Doctoral thesis
Full Text Status:Public
Agris subject categories.:L Animal production > L70 Veterinary science and hygiene - General aspects
Subjects:(A) Swedish standard research categories 2011 > 4 Agricultural Sciences > 403 Veterinary Science > Clinical Science
Agrovoc terms:horses, staphylococcus aureus, resistance to antibiotics, penicillins, antimicrobials, disease control, animal hospitals, veterinary medicine
Keywords:horses , equine, methicillin-resistant Staphylococcus aureus, MRSA, infection prevention and control
Permanent URL:
ID Code:10435
Faculty:VH - Faculty of Veterinary Medicine and Animal Science
Department:(VH) > Dept. of Animal Environment and Health
External funders:Swedish Board of Agriculture and Stiftelsen Hästforskning
Deposited By: Dr Taeda Tomic
Deposited On:13 May 2013 09:28
Metadata Last Modified:13 Dec 2014 21:37

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