Evaluation of Methicillin-Resistant Staphylococcus aureus Carriage and High Livestock Production Areas in North Carolina through Active Case Finding at a Tertiary Care Hospital.

Recent reports from the Netherlands document the emergence of novel multilocus sequence typing (MLST) types (e.g., ST-398) of methicillin-resistant Staphylococcus aureus (MRSA) in livestock, particularly swine. In Eastern North Carolina (NC), one of the densest pig farming areas in the United States, as many as 14% of MRSA isolates from active case finding in our medical center have no matches in a repetitive sequence-based polymerase chain reaction (rep-PCR) library. The current study was designed to determine if these non-matched MRSA (NM-MRSA) were geographically associated with exposure to pig farming in Eastern NC. While residential proximity to farm waste lagoons lacked association with NM-MRSA in a logistic regression model, a spatial cluster was identified in the county with highest pig density. Using MLST, we found a heterogeneous distribution of strain types comprising the NM-MRSA isolates from the most pig dense regions, including ST-5 and ST-398. Our study raises the warning that patients in Eastern NC harbor livestock associated MRSA strains are not easily identifiable by rep-PCR. Future MRSA studies in livestock dense areas in the U.S. should investigate further the role of pig-human interactions.

Comparison of safety and efficacy between first and second generation of angio-seal closure devices in interventional patients.

Arterial closure devices are safe and effective in selected patients, with complication rates similar to or lower than manual compression. The purpose of this study was to compare the safety and efficacy of the first- and new-generation Angio-Seal devices in patients undergoing PCI. This study found that the new Angio-Seal STS Platform device can secure hemostasis after PCI in a safe and effective manner similar to the old device. The new platform is easier for the operator and for the patients.