Are cases of Methicillin-resistant Staphylococcus aureus clonal complex (CC) 398 among humans still livestock-associated?

UNLABELLED: Methicillin-resistant Staphylococcus aureus (MRSA) of clonal complex (CC) 398 are widespread among pigs, cattle and poultry as well as among humans who have contact to these livestock animals. However, there is limited data on livestock-independent dissemination of MRSA CC398 in the general population. METHODS: In this case-control study MRSA isolates derived (between July 2013 and June 2014) from patients of four hospitals located in a livestock-dense region were S. aureus protein A (spa) typed and risk factors for MRSA acquisition were assessed from patients colonized or infected with MRSA CC398 vs. other MRSA molecular types (MRSA non-CC398). RESULTS: Of 384 patients, 21% were colonized with MRSA CC398. Contact with livestock (Odds Ratio (OR) 46.03) and residence directly on a pig farm (OR 12.82) were associated with MRSA CC398. Of 55 patients with MRSA CC398, 21 (38%) did not report direct livestock contact. Among the latter we identified several risk factors that could have facilitated indirect transmission, such as living on farms (without being farmer), private contact with known MRSA carriers or previous hospitalization. DISCUSSION: This study suggests that MRSA CC398 is still mostly disseminated via direct contact to livestock. However, a substantial proportion of patients seem to acquire MRSA CC398 via other pathways.

Factors influencing life satisfaction in acute myeloid leukemia survivors following allogeneic stem cell transplantation: a cross-sectional study.

BACKGROUND: Allogeneic stem cell transplantation (alloSCT) is the preferred option of postremission therapy for high-risk patients suffering from acute myeloid leukemia (AML). Therefore, monitoring life satisfaction (LS) of long-term survivors following alloSCT is becoming increasingly important for oncologists. The aim of the study was to evaluate individual survivor priority of various general and health-related domains of life and their satisfaction with these domains. Furthermore, we investigated the impact of general and health-related LS on resilience, anxiety, depression and quality of life in AML survivors following alloSCT. METHODS: Forty-one AML survivors (median age at time of assessment = 49.0 years) who had undergone alloSCT (median time since transplantation = 3.1 years) were enrolled in the study. Psychosocial parameters were assessed using the following instruments: FLZ(M) (Questions on Life Satisfaction), EORTC QLQ-C30, HADS (Hospital Anxiety and Depression Scale) and the RS-25 (Resilience Scale-25 items). Correlation analyses were computed to reveal the associations between the different questionnaires. RESULTS: Independence from help or care, well-regulated living conditions and financial security contributed positively to LS, whereas being off work due to health-reasons and dissatisfaction with physical aspects were negatively associated to the subjective feelings of overall satisfaction. Moreover, a high quality of life was strongly positively correlated with LS (Spearman's rho general LS: 0.643 and health-related LS: 0.726, both p < 0.001). A high degree of resilience was also strongly positively correlated with better LS (general LS: 0.700, health-related LS: 0.675, both p < 0.001). Symptoms of anxiety and depression were associated with an impaired general LS (anxiety: -0.674, depression: -0.698, both p < 0.001). CONCLUSIONS: Our results indicate that LS should be considered an important key contributor to the survivors' well-being following alloSCT. Thus, identifying protective psychological and physical factors that relieve stressors is of high importance in order to support long-term AML survivors with their special needs.