Face mask use and persistence of livestock-associated Staphylococcus aureus nasal carriage among industrial hog operation workers and household contacts, USA.
Nadimpalli ML; Stewart JR; Pierce E; Pisanic N; Love DC; Hall D; Larsen J; Carroll KC; Tekle T; Perl TM; Heaney CD
Environ Health Perspect 2018 Dec; 126(12):127005
BACKGROUND: Industrial hog operation (IHO) workers may persistently carry antibiotic-resistant, livestock-associated Staphylococcus aureus in their nasal cavities. It is unclear whether IHO work activities can alter IHO workers' and their household members' exposure to these bacteria. OBJECTIVE: Our objective was to investigate the relationship of IHO work activities with persistence of antibiotic-resistant, livestock-associated S. aureus nasal carriage among IHO workers and their household members. METHODS: At biweekly intervals over 4 months, IHO workers and their household members completed questionnaires and provided nasal swabs that were assessed for S. aureus, multidrug-resistant S. aureus (MDRSA), and livestock-associated markers (tetracycline resistance, scn absence, spa type). We examined the association between transient and habitual IHO work activities and S. aureus nasal carriage outcomes. RESULTS: One hundred one IHO workers and 79 household members completed 1,456 study visits. Face mask use (each 25% increase) was associated with reduced odds of nasal carriage of MDRSA (odds ratio [OR]: 0.65 [95% confidence interval (CI): 0.46, 0.92], tetracycline-resistant S. aureus [OR = 0.74 (95% CI: 0.56, 0.97)], and S. aureus clonal complex (CC) 398/CC9 [OR = 0.77 (95% CI: 0.60, 0.99)]. IHO workers who ever (vs. never) gave pigs injections had higher odds of these outcomes. Among household members, living with an IHO worker who consistently (>/= 80% of the time) versus sometimes or never used a face mask was associated with reduced odds of carrying scn-negative S. aureus, tetracycline-resistant S. aureus, and S. aureus CC398/CC9 (OR range: 0.12. 0.20, all <0:05), and consistent IHO worker coveralls use was associated with reduced odds of household member MDRSA carriage only. Living with an IHO worker who habitually had contact with >/= 4,000 hogs (vs. < 4000) was associated with higher odds of household member livestock-associated S. aureus carriage. CONCLUSIONS: Consistent face mask use was associated with reduced exposure to antibiotic-resistant, livestock-associated S. aureus among IHO workers and their household members.
Staphylococcus aureus; Agriculture; Livestock; Animals; Humans; Men; Women; Children; Families; Questionnaires; Methicillin Resistant Staphylococcus aureus; MRSA; Statistical analysis; Animal handlers; Animal husbandry workers; Livestock industry; Agricultural workers; Take-home toxins; Face masks; Personal protective equipment; PPE; Antimicrobial resistance; Bacteria; Bacterial infections; Nasal cavity; Staphylococcus aureus infection
C. D. Heaney, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
Environmental Health Perspectives
Johns Hopkins University, Baltimore, Maryland