MRSA aus Sicht des RKI: Nachweise bei Menschen und anderen Tieren - eine kommende Zoonose?

For a long time MRSA were associated only with human medicine, although with increased incidence in human medicine, MRSA was almost simultaneously reported to occur in veterinary medicine as well. Following initial intermittent reports of appearances of MRSA in cattle and milkers, clusters of nosocomial infections in various animal species in several European as well as one Canadian animal hospital stated. During 2003-2007 the cluster of MRSA ST 254, t036 and MRSA ST 398, t011/ t034 were isolated from wound infections in hospitalised horses as well as from nasal swabs from horses and from veterinary staff in a horse clinic at the veterinary university Vienna (VUW). MRSA ST 1, t127 were for first time detected in infect localisations solely in three horses. Considered epidemiologically, MRSA ST 254, t009 is known as Hannover-epidemic strain from health care settings. However, with the spa-type and the SCCmec-element IVc it exhibits two major differences and is therefore definitely distinct from the MRSA ST 254 found in horses and veterinary employees from UVW. With respect to evolution both lineages evolved independently from on another but can be ascribed to a common ancestor within the clonal complex CC8. MRSA ST 398, in 2003 observed for the first time as MSSA in pigs in France, was first detected in horses in 2006 following augmented confirmations at the VUW in 2007. Although the primary reservoir of MRSA ST398 is obviously in pigs as also recorded in Germany, it is obviously to colonize and to cause infections in other host species such as humans, cattle, dogs, cats and poultry. Infections in hospitals in individuals even without contact to animals and two cases with death in exceptional severe situation point at the pronounced patho-potency. Its flexibility concerning host adaptation and acquisition of additional virulence genes gets the claim for the obligation to report MRSA cases. The proportion of MRSA ST398 among infections in humans is infrequent so far, mainly patients with direct or familial contacts to livestock are affected. There were, however, also a few cases of invasive nosocomial infections in patients without any association to animal husbandry. This underlines the necessity for further surveillance of the evolution of MRSA ST398 and its dissemination.

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