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Comment & Response |

Identifying Livestock-Associated Methicillin-Resistant Staphylococcus aureus in the United States

Eli N. Perencevich, MD, MS1; Robert Skov, MD2; Jan Kluytmans, MD, PhD3
[+] Author Affiliations
1Carver College of Medicine, University of Iowa, Iowa City
2Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
3Laboratory for Microbiology and Infection Control, Amphia Hospital, Breda, the Netherlands
JAMA Intern Med. 2014;174(5):824-825. doi:10.1001/jamainternmed.2014.45.
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To the Editor Livestock density in the Netherlands has been identified as a risk factor for livestock-associated methicillin-resistant Staphylococcus aureus (MRSA) in individuals not engaged in livestock production.1 Thus, we read with interest the report by Casey et al2 that identified proximity to swine manure application to crop fields as a risk factor for MRSA infection and skin and soft-tissue infection. While the analysis appears sound, we have questions concerning how infections were identified in the study and the specific strains identified.

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May 1, 2014
Joan A. Casey, MA; Brian S. Schwartz, MD
1Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland3Johns Hopkins Center for a Livable Future, Baltimore, Maryland
1Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland4Johns Hopkins School of Medicine, Baltimore, Maryland5Geisinger Health System, Danville, Pennsylvania
JAMA Intern Med. 2014;174(5):825. doi:10.1001/jamainternmed.2014.37.
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