Exposure to Pig Farms and Manure Fertilizers Associated with MRSA Infections

Released: 16-Sep-2013 9:00 AM EDT
Source Newsroom: Geisinger Health System
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Citations JAMA Internal Medicine

Newswise — DANVILLE, Pa - Researchers from Geisinger’s Henry Hood Center for Health Research and Johns Hopkins Bloomberg School of Public Health have for the first time found an association between living in proximity to high-density livestock production and community-acquired infections with methicillin-resistant Staphylococcus aureus, commonly known as MRSA.

Their analysis concluded that approximately 11 percent of community-acquired MRSA and soft tissue infections in the study population could be attributed to crop fields fertilized with swine manure. The study is the first to examine the association between high-density livestock operations and manure-applied crop fields and MRSA infections in the community.
The results were published online Sept. 16 in JAMA Internal Medicine.

According to the U.S. Food and Drug Administration, nearly 80 percent of antibiotics in the United States are sold for use in livestock feeds. The manure produced by these livestock and applied to crop fields contains antibiotic-resistant bacteria, resistance genes, and about 75 percent of the antibiotics consumed by the animals.

For the study, researchers utilized Geisinger’s sophisticated electronic health record system to identify patients with MRSA infections and skin and soft tissue infections. The two groups were compared to patients who never had a MRSA infection. Patients received an exposure score based on their distance from the production, the number of animals at livestock operations, the amount of manure spread on crop fields, and the size of the field. The researchers noted that between 2005 and 2010 there were about 3,000 patients with MRSA and 50,000 with skin and soft tissue infections who were diagnosed and treated in the Geisinger Health System.

Of these cases, 1,539 cases of community-associated MRSA and 1,335 cases of health-care-associated MRSA met the study requirements. The researchers found a significant association between community-associated MRSA and application of swine manure to crop fields. A similar but weaker association was found between swine operations and community-associated MRSA. No association was found between dairy farms and MRSA infections.

“The study shows the utility of electronic health records for demonstrating the unrecognized public health consequences of operations with environmental impacts,” said Brian Schwartz, M.D., MS, senior author and environmental epidemiologist who splits his time between Geisinger Health System and Bloomberg School’s Department of Environmental Health Sciences.

Funding for the research was provided by the New York University-Geisinger Seed Grant Program, the Johns Hopkins Center for a Livable Future, the Johns Hopkins Sommer Scholarship and the National Institute of Environmental Health Sciences Training Grant ES07141.

About MRSA Precautions at Geisinger
According to Lisa M. Esolen, M.D., director, infection control at Geisinger, anyone identified as having a community or hospital-acquired MRSA infection is placed under special precautions called “Contact Precautions” to minimize the spread to others. In addition, after a patient treated with MRSA is discharged from the hospital and the room is traditionally cleaned, Geisinger uses robotic cleaning technology to disinfect the room, including the use of ultraviolet light.

About Geisinger Health System
Geisinger Health System is an integrated health services organization widely recognized for its innovative use of the electronic health record, and the development of innovative care models such as ProvenHealth Navigator® and ProvenCare®. As the nation’s largest rural health services organization, Geisinger serves more than 2.6 million residents throughout 44 counties in central and northeastern Pennsylvania. The physician-led system is comprised of more than 19,500 employees, including a 1,000-member multi-specialty group practice, six hospital campuses, two research centers and a 448,000-member health plan, all of which leverage an estimated $6.1 billion positive impact on the Pennsylvania economy. The health system and the health plan have repeatedly garnered national accolades for integration, quality and service. In addition to fulfilling its patient care mission, Geisinger has a long-standing commitment to medical education, research and community service. For more information, visit www.geisinger.org, or follow the latest Geisinger news and more on Twitter and Facebook.


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