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Christiane Cuny
Department Infectious Diseases, Robert-Koch Institute (RKI), 38855 Wernigerode, Germany

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Journal article
Published: 21 May 2021 in Microorganisms
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Methicillin-resistant Staphylococcusaureus (MRSA) are a major threat to human and animal health, causing difficult-to-treat infections. The aim of our study was to evaluate the intra-farm transmission of livestock-associated (LA) MRSA sequence type (ST) 398 isolates on German dairy farms. A total of 115 LA-MRSA ST398 isolates originating from animals, humans and the environment of six dairy farms were analyzed by whole-genome sequencing and core genome multilocus sequence typing. Phylogenetic clusters of high allelic similarity were detected on all dairy farms, suggesting a MRSA transmission across the different niches. On one farm, closely related isolates from quarter milk samples (QMS), suckers of calf feeders and nasal cavities of calves indicate that MRSA may be transferred by feeding contaminated milk to calves. Detection of related MRSA isolates in QMS and teat cups (4/6 farms) or QMS and human samples (3/4 farms) pointed out a transmission of MRSA between cows during the milking process and a potential zoonotic risk. In conclusion, LA-MRSA ST398 isolates may spread between animals, humans and the environment on dairy farms. Milking time hygiene and other internal biosecurity measures on farms and pre-treatment of milk before feeding it to calves may reduce the risk of MRSA transmission.

ACS Style

Tobias Lienen; Arne Schnitt; Christiane Cuny; Sven Maurischat; Bernd-Alois Tenhagen. Phylogenetic Tracking of LA-MRSA ST398 Intra-Farm Transmission among Animals, Humans and the Environment on German Dairy Farms. Microorganisms 2021, 9, 1119 .

AMA Style

Tobias Lienen, Arne Schnitt, Christiane Cuny, Sven Maurischat, Bernd-Alois Tenhagen. Phylogenetic Tracking of LA-MRSA ST398 Intra-Farm Transmission among Animals, Humans and the Environment on German Dairy Farms. Microorganisms. 2021; 9 (6):1119.

Chicago/Turabian Style

Tobias Lienen; Arne Schnitt; Christiane Cuny; Sven Maurischat; Bernd-Alois Tenhagen. 2021. "Phylogenetic Tracking of LA-MRSA ST398 Intra-Farm Transmission among Animals, Humans and the Environment on German Dairy Farms." Microorganisms 9, no. 6: 1119.

Journal article
Published: 22 July 2019 in Antimicrobial Resistance & Infection Control
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Recent publications have raised concerns of reduced susceptibilities of clinical bacterial isolates towards biocides. This study presents a comparative investigation of the susceptibility of livestock-associated Methicillin-resistant Staphylococcus aureus (LA-MRSA), hospital-acquired MRSA (HA-MRSA) and community-aquired MRSA (CA-MRSA) to the commonly used antiseptics chlorhexidine (CHX), octenidine (OCT), polyhexanide (PHMB), PVP-iodine (PVP-I) and triclosan (TCX) based on internationally accepted standards. In total, 28 (18 LA-, 5 HA- and 5 CA) genetically characterized MRSA strains representing a broad spectrum of hosts, clonal complexes and spa-types, as well as the reference methicillin-sensitive Staphylococcus aureus (MSSA) strain ATCC 6538, were selected. Minimal inhibitory concentration (MIC) and minimal microbicidal concentration (MBC) were determined in accordance with DIN 58940–7, 58940–8 and DIN EN ISO 20776-1. The microbicidal efficacy was determined in accordance with DIN EN 1040. Results from the MIC/MBC and quantitative suspension tests revealed differences between antiseptic substances but not between epidemiological groups of MRSA strains. OCT and PHMB were the most active substances with a minimal MIC of 1 mg/L, followed by CHX (2 mg/L), TCX (32 mg/L) and finally PVP-I (1024 mg/L). The MSSA reference strain showed a tendency to a higher susceptibility compared to the MRSA strains. This investigation of the susceptibility of a range of LA-, HA- and CA-MRSA strains using standardized conditions gave no indication that LA-MRSA strains are less susceptible to commonly used antiseptics compared to HA- and CA-MRSA strains.

ACS Style

Kathleen Dittmann; Thomas Schmidt; Gerald Müller; Christiane Cuny; Silva Holtfreter; Daniel Troitzsch; Peter Pfaff; Nils-Olaf Hübner. Susceptibility of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) to chlorhexidine digluconate, octenidine dihydrochloride, polyhexanide, PVP-iodine and triclosan in comparison to hospital-acquired MRSA (HA-MRSA) and community-aquired MRSA (CA-MRSA): a standardized comparison. Antimicrobial Resistance & Infection Control 2019, 8, 1 -9.

AMA Style

Kathleen Dittmann, Thomas Schmidt, Gerald Müller, Christiane Cuny, Silva Holtfreter, Daniel Troitzsch, Peter Pfaff, Nils-Olaf Hübner. Susceptibility of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) to chlorhexidine digluconate, octenidine dihydrochloride, polyhexanide, PVP-iodine and triclosan in comparison to hospital-acquired MRSA (HA-MRSA) and community-aquired MRSA (CA-MRSA): a standardized comparison. Antimicrobial Resistance & Infection Control. 2019; 8 (1):1-9.

Chicago/Turabian Style

Kathleen Dittmann; Thomas Schmidt; Gerald Müller; Christiane Cuny; Silva Holtfreter; Daniel Troitzsch; Peter Pfaff; Nils-Olaf Hübner. 2019. "Susceptibility of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) to chlorhexidine digluconate, octenidine dihydrochloride, polyhexanide, PVP-iodine and triclosan in comparison to hospital-acquired MRSA (HA-MRSA) and community-aquired MRSA (CA-MRSA): a standardized comparison." Antimicrobial Resistance & Infection Control 8, no. 1: 1-9.

Journal article
Published: 30 March 2019 in Toxins
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Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) is widely disseminated as a nasal colonizer of conventionally raised livestock and of humans subjected to occupational exposure. Reports on contamination of raw meat raise the question as to whether occupationally exposed food handlers are at particular risk of nasal colonization by LA-MRSA. Here, we report the results from a cross-sectional study on nasal S. aureus/MRSA colonization of butchers, meat sellers, and cooks in Germany. We sampled 286 butchers and meat sellers in 26 butcheries and 319 cooks handling meat in 16 professional canteen kitchens. Swabs were processed on both blood agar plates and MRSA-selective plates. MRSA were confirmed by PCR for mec genes and by broth microdilution. All isolates were subjected to molecular typing. PCR for markers useful to differentiate human-adapted and animal-adapted subpopulations was performed due to the presence of clonal complexes known to occur in both livestock and humans (CC5, CC7, CC8, CC9, and CC398). Only two participants (0.33%) were colonized by MRSA (Hospital-associated MRSA ST22). Nasal colonization by methicillin-susceptible S. aureus (MSSA) was detected in 16.6% of cooks and in 26.2% of butchers and meat sellers. Among 16 of the isolates attributed to CC7, three were negative for the immune evasion gene cluster, suggesting an animal origin. Isolates attributed to CC5, CC8, and CC398 were negative for markers typical of animal-adapted subpopulations. The occupational handling of raw meat and raw meat products was not associated with nasal colonization by LA-MRSA.

ACS Style

Christiane Cuny; Franziska Layer; Sonja Hansen; Guido Werner; Wolfgang Witte. Nasal Colonization of Humans with Occupational Exposure to Raw Meat and to Raw Meat Products with Methicillin-Susceptible and Methicillin-Resistant Staphylococcus aureus. Toxins 2019, 11, 190 .

AMA Style

Christiane Cuny, Franziska Layer, Sonja Hansen, Guido Werner, Wolfgang Witte. Nasal Colonization of Humans with Occupational Exposure to Raw Meat and to Raw Meat Products with Methicillin-Susceptible and Methicillin-Resistant Staphylococcus aureus. Toxins. 2019; 11 (4):190.

Chicago/Turabian Style

Christiane Cuny; Franziska Layer; Sonja Hansen; Guido Werner; Wolfgang Witte. 2019. "Nasal Colonization of Humans with Occupational Exposure to Raw Meat and to Raw Meat Products with Methicillin-Susceptible and Methicillin-Resistant Staphylococcus aureus." Toxins 11, no. 4: 190.

Review
Published: 01 February 2017 in Veterinary Microbiology
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MRSA infections in equine clinics were reported from Northern America, Europe, Australia, and Japan. The majority of nosocomial infections in horses is obviously associated with particular MRSA clonal lineages. As already observed for epidemic MRSA in human hospitals more than 10 years ago, a dynamics of MRSA clonal lineages is also observed in European equine clinics: clonal lineages belonging to clonal complex (CC) 8 are on the retreat whereas MRSA attributed to CC398 become increasingly prevalent. The majority of CC398 isolates belong to a subpopulation which is particularly associated with equine hospitals as indicated by molecular typing. When emerging in equine clinics, MRSA from horses were also found as nasal colonizers of veterinary personnel. MRSA exhibiting the typing characteristics of MRSA known from equine clinics are obviously rare among MRSA from infections in humans. Although rare so far epidemic MRSA from human hospitals (HA-MRSA, e.g., ST22, ST225) have been isolated from nosocomial infections in horses and need particular attention in further surveillance.

ACS Style

Christiane Cuny; Wolfgang Witte. MRSA in equine hospitals and its significance for infections in humans. Veterinary Microbiology 2017, 200, 59 -64.

AMA Style

Christiane Cuny, Wolfgang Witte. MRSA in equine hospitals and its significance for infections in humans. Veterinary Microbiology. 2017; 200 ():59-64.

Chicago/Turabian Style

Christiane Cuny; Wolfgang Witte. 2017. "MRSA in equine hospitals and its significance for infections in humans." Veterinary Microbiology 200, no. : 59-64.

Fachspiegel
Published: 14 December 2015 in pferde spiegel
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Staphylococcus aureus sind als asymptomatische Besiedler und Verursacher einer Vielzahl verschiedener Infektionen des Haut- und Weichgewebes bei Menschen und Tieren bekannt. Jahrzehntelang waren Methicillin-resistente S. aureus (MRSA) vor allem bei Menschen als nosokomiale Infektionserreger verbreitet und aufgrund ihres epidemischen Auftretens in verschiedenen Bereichen des Gesundheitswesens sowie der eingeschränkten therapeutischen Möglichkeiten gefürchtet. In zunehmendem Maße werden MRSA auch in der Allgemeinbevölkerung, in der landwirtschaftlichen Nutztierhaltung (Livestock-Associated MRSA, LA-MRSA) und bei Haus- und Hobbytieren nachgewiesen. Trotz weiterbestehender genotypischer Unterschiede zwischen „menschlichen“ und „tierischen“ MRSA konnte eine epidemiologische Schnittmenge ausgemacht werden, die wechselseitig zwischen Menschen und Tieren übertragen wird und auf die Erweiterung ihres Wirtsspektrums hindeutet. Diese Übersichtsarbeit stellt den derzeitigen Stand des Wissens zur zoonotischen Bedeutung der wechselseitigen Transmission von MRSA zwischen Menschen und Pferden in Deutschland dar.

ACS Style

Christiane Cuny; Reinhold Böse; Wolfgang Scheidemann; Wolfgang Witte. Auftreten und Verbreitung von Methicillin-resistenten Staphylococcus aureus in Pferdekliniken. pferde spiegel 2015, 18, 152 -158.

AMA Style

Christiane Cuny, Reinhold Böse, Wolfgang Scheidemann, Wolfgang Witte. Auftreten und Verbreitung von Methicillin-resistenten Staphylococcus aureus in Pferdekliniken. pferde spiegel. 2015; 18 (04):152-158.

Chicago/Turabian Style

Christiane Cuny; Reinhold Böse; Wolfgang Scheidemann; Wolfgang Witte. 2015. "Auftreten und Verbreitung von Methicillin-resistenten Staphylococcus aureus in Pferdekliniken." pferde spiegel 18, no. 04: 152-158.

Journal article
Published: 12 December 2015 in One Health
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A total of 272 methicillin-resistant Staphylococcus aureus (MRSA) from equine infections originating from 17 equine hospitals and 39 veterinary practices in Germany as well as 67 isolates from personnel working at equine clinics were subjected to molecular typing. The majority of isolates from horses was attributed to clonal complex (CC) 398 (82.7%). Within CC398, 66% of isolates belonged to a subpopulation (clade) of CC398, which is associated with equine clinics. MRSA attributed to CC8 (ST254, t009, t036, SCCmecIV; ST8, t064, SCCmecIV) were less frequent (16.5%). Single isolates were attributed to ST1, CC22, ST130, and ST1660. The emergence of MRSA CC22 and ST130 in horses was not reported so far. Nasal MRSA colonization was found in 19.5% of veterinary personnel with occupational exposure to horses. The typing characteristics of these isolates corresponded to isolates from equine infections. Comparing typing characteristics of equine isolates with those of a substantial number of isolates from human infections typed at the German Reference Center for Staphylococci and Enterococci (2006–2014; n = 10864) yielded that the proportion of isolates exhibiting characteristics of MRSA from equine medicine is very low (< 0.5%). As this low proportion was also found among MRSA originating from nasal screenings of human carriers not suffering from a staphylococcal infection (n = 5546) transmission of MRSA from equine clinics to the community seems to be rare so far.

ACS Style

Christiane Cuny; Mohamed M.H. Abdelbary; Robin Köck; Franziska Layer; Wolfgang Scheidemann; Guido Werner; Wolfgang Witte. Methicillin-resistant Staphylococcus aureus from infections in horses in Germany are frequent colonizers of veterinarians but rare among MRSA from infections in humans. One Health 2015, 2, 11 -17.

AMA Style

Christiane Cuny, Mohamed M.H. Abdelbary, Robin Köck, Franziska Layer, Wolfgang Scheidemann, Guido Werner, Wolfgang Witte. Methicillin-resistant Staphylococcus aureus from infections in horses in Germany are frequent colonizers of veterinarians but rare among MRSA from infections in humans. One Health. 2015; 2 ():11-17.

Chicago/Turabian Style

Christiane Cuny; Mohamed M.H. Abdelbary; Robin Köck; Franziska Layer; Wolfgang Scheidemann; Guido Werner; Wolfgang Witte. 2015. "Methicillin-resistant Staphylococcus aureus from infections in horses in Germany are frequent colonizers of veterinarians but rare among MRSA from infections in humans." One Health 2, no. : 11-17.

Review
Published: 06 November 2015 in Antibiotics
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During the past 25 years an increase in the prevalence of methicillin-resistant Staphylococcus aureus (HA-MRSA) was recorded worldwide. Additionally, MRSA infections may occur outside and independent of hospitals, caused by community associated MRSA (CA-MRSA). In Germany, we found that at least 10% of these sporadic infections are due to livestock-associated MRSA (LA-MRSA), which is initially associated with livestock. The majority of these MRSA cases are attributed to clonal complex CC398. LA-MRSA CC398 colonizes the animals asymptomatically in about half of conventional pig farms. For about 77%–86% of humans with occupational exposure to pigs, nasal carriage has been reported; it can be lost when exposure is interrupted. Among family members living at the same farms, only 4%–5% are colonized. Spread beyond this group of people is less frequent. The prevalence of LA-MRSA in livestock seems to be influenced by farm size, farming systems, usage of disinfectants, and in-feed zinc. LA-MRSA CC398 is able to cause the same kind of infections in humans as S. aureus and MRSA in general. It can be introduced to hospitals and cause nosocomial infections such as postoperative surgical site infections, ventilator associated pneumonia, septicemia, and infections after joint replacement. For this reason, screening for MRSA colonization at hospital admittance is recommended for farmers and veterinarians with livestock contacts. Intrahospital dissemination, typical for HA-MRSA in the absence of sufficient hygiene, has only rarely been observed for LA-MRSA to date. The proportion of LA-MRSA among all MRSA from nosocomial infections is about 3% across Germany. In geographical areas with a comparatively high density of conventional farms, LA-MRSA accounts for up to 10% of MRSA from septicemia and 15% of MRSA from wound infections. As known from comparative genome analysis, LA-MRSA has evolved from human-adapted methicillin-susceptible S. aureus, and the jump to livestock was obviously associated with several genetic changes. Reversion of the genetic changes and readaptation to humans bears a potential health risk and requires tight surveillance. Although most LA-MRSA (>80%) is resistant to several antibiotics, there are still sufficient treatment options.

ACS Style

Christiane Cuny; Lothar H. Wieler; Wolfgang Witte. Livestock-Associated MRSA: The Impact on Humans. Antibiotics 2015, 4, 521 -543.

AMA Style

Christiane Cuny, Lothar H. Wieler, Wolfgang Witte. Livestock-Associated MRSA: The Impact on Humans. Antibiotics. 2015; 4 (4):521-543.

Chicago/Turabian Style

Christiane Cuny; Lothar H. Wieler; Wolfgang Witte. 2015. "Livestock-Associated MRSA: The Impact on Humans." Antibiotics 4, no. 4: 521-543.

Journal article
Published: 21 August 2014 in Acta Veterinaria Scandinavica
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Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) has a wide host range and is transmissible to humans, especially to those with close contact to colonized animals. This study presents the first data on the occurrence of MRSA in farm workers and livestock farms (pig, cattle and poultry) in the federal state of Mecklenburg-Western Pomerania in northeast Germany. 78 farm workers at pig farms, cattle farms and poultry farms were tested for MRSA via pooled nasal and pharyngeal swabs. Additionally, from each of the 34 participating farms (17 pig farms, 11 cattle farms, 6 poultry farms) five dust samples were taken from the direct surroundings of the animals. Furthermore, oropharyngeal swabs were additionally taken from 10 animals per poultry farm. Isolated MRSA strains were characterized and confirmed using PCR and spa typing. Resistance patterns were obtained using the broth microdilution assay.

ACS Style

Carmen Dahms; Nils-Olaf Hübner; Christiane Cuny; Axel Kramer. Occurrence of methicillin-resistant Staphylococcus aureus in farm workers and the livestock environment in Mecklenburg-Western Pomerania, Germany. Acta Veterinaria Scandinavica 2014, 56, 53 -53.

AMA Style

Carmen Dahms, Nils-Olaf Hübner, Christiane Cuny, Axel Kramer. Occurrence of methicillin-resistant Staphylococcus aureus in farm workers and the livestock environment in Mecklenburg-Western Pomerania, Germany. Acta Veterinaria Scandinavica. 2014; 56 (1):53-53.

Chicago/Turabian Style

Carmen Dahms; Nils-Olaf Hübner; Christiane Cuny; Axel Kramer. 2014. "Occurrence of methicillin-resistant Staphylococcus aureus in farm workers and the livestock environment in Mecklenburg-Western Pomerania, Germany." Acta Veterinaria Scandinavica 56, no. 1: 53-53.

Review
Published: 01 August 2013 in International Journal of Medical Microbiology
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Livestock-associated Staphylococcus aureus (LA-MRSA) are mainly associated with the clonal complex (CC) 398. Although having its main reservoir as MRSA in livestock such as pigs, poultry or cattle LA-MRSA CC398 has no pronounced host specificity and can colonize or infect other animals such as horses and dogs and also humans. In German conventional farming systems nasal colonization of the animals and of humans occupationally exposed to them (up to 86%) are frequent. Further human-to-human dissemination in households occurs more rarely in general (∼4% of humans living on farms but without occupational exposition). Nasal colonization with LA-MRSA of humans at hospital admission is found in 0.08-0.2% for Germany in general. However, this proportion is higher in areas with a high density of livestock production such as in northwestern North Rhine-Westphalia or Lower Saxony. LA-MRSA CC398 is not less pathogenic for humans than S. aureus in general. Hence, LA-MRSA accounts for ∼15% of all MRSA isolates from deep-seated skin and soft-tissue infections in the community and for about 0.8-2% of all MRSA isolated from clinical specimens obtained in hospital settings. When introduced into the hospital it can cause postoperative wound infections and even septicemia. Differently from hospital-associated MRSA clones, LA-MRSA CC398 has obviously limited capacity to spread in the nosocomial setting so far (proportion of ∼1.8% among MRSA from nosocomial infections, the proportion among MRSA from blood cultures is ∼1%).

ACS Style

Christiane Cuny; Robin Köck; Wolfgang Witte. Livestock associated MRSA (LA-MRSA) and its relevance for humans in Germany. International Journal of Medical Microbiology 2013, 303, 331 -337.

AMA Style

Christiane Cuny, Robin Köck, Wolfgang Witte. Livestock associated MRSA (LA-MRSA) and its relevance for humans in Germany. International Journal of Medical Microbiology. 2013; 303 (6-7):331-337.

Chicago/Turabian Style

Christiane Cuny; Robin Köck; Wolfgang Witte. 2013. "Livestock associated MRSA (LA-MRSA) and its relevance for humans in Germany." International Journal of Medical Microbiology 303, no. 6-7: 331-337.

Journal article
Published: 15 February 2012 in Applied and Environmental Microbiology
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Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) ST398 isolated from pigs raised in conventional farms was previously reported. Here we report a study on 25 farms adhering to an alternative system. LA-MRSA ST398 was not detected in nasal swabs from 178 pigs or from 89 humans working and living on these farms.

ACS Style

Christiane Cuny; Alexander W. Friedrich; Wolfgang Witte. Absence of Livestock-Associated Methicillin-Resistant Staphylococcus aureus Clonal Complex CC398 as a Nasal Colonizer of Pigs Raised in an Alternative System. Applied and Environmental Microbiology 2012, 78, 1296 -1297.

AMA Style

Christiane Cuny, Alexander W. Friedrich, Wolfgang Witte. Absence of Livestock-Associated Methicillin-Resistant Staphylococcus aureus Clonal Complex CC398 as a Nasal Colonizer of Pigs Raised in an Alternative System. Applied and Environmental Microbiology. 2012; 78 (4):1296-1297.

Chicago/Turabian Style

Christiane Cuny; Alexander W. Friedrich; Wolfgang Witte. 2012. "Absence of Livestock-Associated Methicillin-Resistant Staphylococcus aureus Clonal Complex CC398 as a Nasal Colonizer of Pigs Raised in an Alternative System." Applied and Environmental Microbiology 78, no. 4: 1296-1297.