Local and Transboundary Transmissions of Methicillin-Resistant Staphylococcus aureus Sequence Type 398 through Pig Trading.

Livestock-associated methicillin-resistant Staphylococcus aureus sequence type (ST) 398 (LA-MRSA ST398) is a genetic lineage for which pigs are regarded as the main reservoir. An increasing prevalence of LA-MRSA ST398 has been reported in areas with high livestock density throughout Europe. In this study, we investigated the drivers contributing to the introduction and spread of LA-MRSA ST398 through the pig farming system in southern Italy. Whole-genome sequencing (WGS) of LA-MRSA ST398 isolates collected in 2018 from pigs (n = 53) and employees (n = 14) from 10 farms in the Calabria region of Italy were comparatively analyzed with previously published WGS data from Italian ST398 isolates (n = 45), an international ST398 reference collection (n = 89), and isolates from Danish pig farms (n = 283), which are the main suppliers of pigs imported to Italy. Single-nucleotide polymorphisms (SNP) were used to infer isolate relatedness, and these data were used together with data from animal trading to identify factors contributing to LA-MRSA ST398 dissemination. The analyses support the existence of two concurrent pathways for the spread of LA-MRSA ST398 in southern Italy: (i) multiple introductions of LA-MRSA ST398 through the import of colonized pigs from other European countries, including Denmark and France, and (ii) the spread of distinct clones dependent on local trading of pigs between farms. Phylogenetically related Italian and Danish LA-MRSA ST398 isolates shared extensive similarities, including carriage of antimicrobial resistance genes. Our findings highlight the potential risk of transboundary transmission of antimicrobial-resistant bacterial clones with a high zoonotic potential during import of pigs from countries with high LA-MRSA prevalence.IMPORTANCE Over the past decade, livestock-associated methicillin-resistant Staphylococcus aureus sequence type 398 (LA-MRSA ST398) has spread among pig holdings throughout Europe, in parallel with the increased incidence of infections among humans, especially in intensive pig farming regions. Despite the growing prevalence of LA-MRSA ST398 in Italian pig farms, the transmission dynamics of this clone in Italy remains unclear. This work provides genome-based evidence to suggest transboundary LA-MRSA ST398 transmission through trading of colonized pigs between European countries and Italy, as well as between farms in the same Italian region. Our findings show that both international trading and local trading of colonized pigs are important factors contributing to the global spread of LA-MRSA ST398 and underscore the need for control measures on and off the farm to reduce the dissemination of this zoonotic pathogen.

Prevalence, molecular epidemiology, and antimicrobial resistance of methicillin-resistant Staphylococcus aureus from swine in southern Italy.

BACKGROUND: Colonization by livestock-associated MRSA (LA-MRSA) has increasingly been reported in the swine population worldwide. The aim of this study was to assess the prevalence of MRSA nasal carriage in healthy pigs, including the black (Calabrese) breed, from farms in the Calabria Region (Southern Italy). Between January and March 2018, a total of 475 healthy pigs reared in 32 farms were sampled by nasal swabbing. MRSA isolates were characterized by spa, MLST and SCCmec typing, and susceptibility testing to 17 antimicrobials. RESULTS: 22 of 32 (66.8%) pig farms resulted positive for MRSA. The prevalence of MRSA was 46.1% (219 MRSA culture-positive out of 475 samples). MRSA colonization was significantly higher in intensive farms and in pigs with a recent or ongoing antimicrobial treatment. All 219 MRSA isolates were assigned to ST398. The most common spa types were t011 (37.0%), t034 (22.4%) and t899 (15.1%). A novel spa type (t18290) was detected in one isolate. An insertion of IS256 in the ST398-specific A07 fragment of the SAPIG2195 gene was detected in 10 out of 81 t011 isolates. Nearly all isolates carried the SCCmec type V element, except 11 isolates that carried the SCCmec type IVc. None of the isolates was positive for the Panton-Valentine leukocidin. All isolates were resistant to tetracycline. High resistance rates were also found for clindamycin (93.1%), trimethoprim/sulfamethoxazole (68.4%), fluoroquinolones (47.9-65.3%) and erythromycin (46.1%). None of the isolates was resistant to vancomycin and fusidic acid. Overall, a multidrug resistant phenotype was observed in 88.6% of isolates. CONCLUSIONS: We report a high prevalence of MRSA among healthy swine in Southern Italy farms, with higher isolation frequency associated with intensive farming. The epidemiological types identified in our study reflect those reported in other European countries. Our findings underscore the importance of monitoring the evolution of LA-MRSA in pig farms in order to implement control measures and reduce the risk of spread in the animal population.

Exposure to airborne mycotoxins: the riskiest working environments and tasks.

OBJECTIVES: There is growing interest in the role of airborne mycotoxins in occupational environments, however, their impact on human health still remains poorly investigated. This review aims to provide a comprehensive analysis of the existing literature on the occurrence of inhalable mycotoxins in working environments to investigate which sectors and tasks are at greater risk of exposure. METHODS: We have performed a systematic search in the PubMed, Scopus and Web of Science databases from 2010 to date, without limitation of geographic location. RESULTS: Database searches yielded 350 articles. After the removal of duplicates and applying our inclusion and exclusion criteria, 31 papers remained. Results show that the most exposed workers are those engaged in activities related to animal care and management and, in particular, in feeding tasks, while harvester cleaning seems to be the activity with the highest levels of exposure in agriculture. In healthcare settings mycotoxin concentrations are low but HVAC systems can be a source of contamination and this reinforces the relevance of further studies in this sector. The most common scenario is the exposure to multiple mycotoxins with variable concentrations depending on the working environment, the products handled or the tasks performed by workers. Some authors emphasize the importance of multi-approach sampling and analysis protocols to achieve an accurate and more realistic risk characterization. CONCLUSIONS: Results brought forward by this review can be utilized by health and safety professionals to recognize activities in which workers may be potentially exposed to airborne mycotoxins and thus undertake suitable preventive and protective measures.

Airborne microorganisms, endotoxin, and dust concentration in wood factories in Italy.

Exposure to biological agents and dusts occurs in homes and occupational environments and it is known to cause adverse health effects. There is limited information concerning the occupational exposure levels of airborne biohazard during wood processing, but this exposure is associated with a range of adverse health effects. Control of exposure to microbiological hazards and dust in woodworking is not easy. In fact, various types of wood are commonly used and they generate complex mixtures of dusts and biological agents with various health risks. The aim of this study was to investigate the concentration of dust, bacteria, and endotoxins encountered in six different wood factories. These people were exposed to between 0.05 and 12.00 mg inhalable dust m(-3) and between 0.40 and 6.93 ng inhalable endotoxins m(-3). Total bacteria concentrations in the air of the factories examined were within a range of 130-2000 CFU m(-3), the value of Gram negative was within a 0-164 CFU m(-3), and the concentration of Gram positive was within 1-104 CFU m(-3). In conclusion, people working in wood factories may be exposed to high levels of inhalable dust and endotoxins.

Viable but nonculturable state of foodborne pathogens in grapefruit juice: a study of laboratory.

Several foodborne human pathogens, when exposed to harsh conditions, enter viable but nonculturable (VBNC) state; however, still open is the question whether VBNC pathogens could be a risk for public health, because, potentially, they can resuscitate. Moreover, cultural methods for food safety control were not able to detect VBNC forms of foodborne bacteria. Particularly, it has not been established whether food chemophysical characteristics can induce VBNC state in contaminating pathogen bacterial populations, especially in food, such as salads and fresh fruit juices, not subjected to any decontamination treatment. In this preliminary study, we intentionally contaminated grapefruit juice to determine whether pathogen bacteria could enter VNBC state. In fact, grapefruit juice contains natural antimicrobial compounds, has an average pH of about 3 and low content in carbohydrates. Such characteristics make grapefruit juice a harsh environment for microbial survival. For this purpose, Escherichia coli O157:H7, Salmonella enterica serovar Typhimurium ATCC 14028, Listeria monocytogenes ATCC 7644, and Shigella flexneri ATCC 12022, at two different inoculum sizes, have been used. Viability by the LIVE/DEAD BacLight Bacterial Viability kit and culturability by plate counts assay were monitored, whereas "resuscitation" of nonculturable populations was attempted by inoculation in nutrient-rich media. The data showed that L. monocytogenes lost both culturability and viability and did not resuscitate within 24 h independently on inoculum size, whereas E. coli O157:H7 was able to resuscitate after 24 h but did not after 48 h. Salmonella Typhimurium and S. flexneri, depending on inoculum size, lost culturability but maintained viability and were able to resuscitate; moreover, S. flexneri was still able to form colonies after 48 h at high inoculum size. In conclusion, entry into VBNC state differs on the species, depending, in turn, on inoculum size and time of incubation.

Seroprevalence and phylogenetic characterization of hepatitis E virus in pig farms in Southern Italy.

Hepatitis E virus (HEV) infection is an emerging public health problem in industrialized countries. The infection is associated with waterborne epidemics and transmitted via faecal-oral route. Zoonotic cases of HEV in humans have increased in Europe, and HEV genotype 3 (HEV-3) is the most frequent among humans and animals. Nevertheless, HEV surveillance in the Italian pig farming industry is patchy. Here, HEV prevalence in pig farms located in the Calabria region in Southern Italy was investigated. A total of 692 serum samples were collected from 26 farms and tested for anti-HEV IgG antibody detection. The percentage of HEV-seropositive pigs was 56.8 %. Small farm size, farrow-to-finishing production, and infrequent cleaning procedures were associated with higher HEV seroprevalence. In 12 of the HEV-seropositive farms, 67 faecal samples were collected and 10 of these (10.6 %) tested positive for HEV RNA. Seven of 10 viral RNA sequences were genotyped for phylogenetic analysis, five of which belonged to subtype HEV-3f and two to subtype HEV-3e. The high HEV seroprevalence and the circulation of HEV-3 strains among domestic pigs in the Calabria region pose a risk for the zoonotic transmission of HEV from pigs to occupational exposed workers.

Presence of Mycobacterium bovis in slaughterhouses and risks for workers.

An investigation was carried out to detect the presence of Mycobacterium bovis in slaughterhouses where intradermal tuberculin test positive cattle were slaughtered, and to evaluate the risk of contamination by M. bovis among exposed slaughterhouse workers. Swabs were taken from the carcasses of slaughtered animals showing autoptic signs of non-generalized forms of tuberculosis, thus authorized for free consumption. Swabs were also taken from the hands and clothes of the staff employed in the butchery production line. Environmental samplings were conducted on the slaughterhouse air using filters and air aspiration devices, and on water used to wash the carcasses after slaughter. Samples from the carcasses of healthy animals were also taken on a following slaughtering session. The swabs were analysed by means of Polymerase Chain Reaction for the detection of mycobacteria. M. bovis was detected on meats, on the hands of one worker, and in the washing water. The results obtained from this study confirm that workers are highly exposed to infection by zoonotic tuberculosis, and that cleaning procedures were ineffective in our setting.

Unidirectional animal-to-human transmission of methicillin-resistant Staphylococcus aureus ST398 in pig farming; evidence from a surveillance study in southern Italy.

Background: Livestock-associated methicillin-resistant Staphylococcus aureus (MRSA) belonging to clonal complex 398 is recognized as an occupational hazard for workers employed in intensive animal husbandry, especially in the swine-breeding chain. In this study, we compared the prevalence and epidemiological type of MRSA isolates from swine and farm workers in a large area of southern Italy. Methods: Between January and March 2018, 88 workers from 32 farms where we had previously performed a survey for MRSA colonization of farmed pigs, were sampled by nasal swabbing. A follow-up investigation was conducted on seven workers 1 year after primary screening. MRSA isolates were characterized by MLST, spa and SCCmec typing, and tested for susceptibility to 15 antimicrobials. Epidemiological correlations between human and swine MRSA isolates were supported by Rep-MP3 and RAPD PCR fingerprinting, and whole-genome sequencing. Results: The overall colonization rate of MRSA in swine farm workers was 21.6%, being significantly higher in intensive farms and in workers with direct animal contact. All human MRSA isolates were multi-drug resistant, belonged to the ST398 livestock clade, and did not carry Panton-Valentine leukocidin and enterotoxin genes. Notably, 94.1% of human MRSA isolates belonged to the same epidemiological type as swine MRSA isolates from the corresponding farm. Persistent MRSA carriage was documented in some workers 1 year after primary sampling. Conclusions: We report a high prevalence of MRSA among swine farm workers, with higher colonization rates associated with intensive breeding and animal exposure. Our findings suggest unidirectional animal-to-human transmission of LA-MRSA and denote the high zoonotic transmissibility of the ST398 livestock clade.

Exposure to airborne endotoxin in Italian greenhouses: environmental analyses.

The peculiar characteristics of the greenhouses as confined spaces, microclimate and poor air exchange with the outside environment, encourage the development of a large number of biological agents. Endotoxin, is probably a major causative agent of occupational health problems. The objective of this study was to measure the concentrations of airborne endotoxin in greenhouses with different cultures. The influence of microclimate was studied in correlation with endotoxin levels and type of cultured vegetables. The data indicate that workers employed greenhouses are exposed to low levels of inhalable endotoxins; endotoxin concentrations do not correlate with the temperature and relative humidity values. A strong correlation between the leaf size and endotoxin concentration was observed. The mean concentration of endotoxins in the air of greenhouses is relatively low, however, there could be peaks of exposure during harvesting and eradication of broadleaf plants.