As a veterinary internist, I’m always looking for a good excuse to harass veterinary surgeons, and a recent study we performed with Dr. Lee Burstiner (an aspiring surgeon but a good guy anyway) at the 2008 American College of Veterinary Surgeons (ACVS) conference gives me more ammunition. This study is being presented today at the European Conference of Clinical Microbiology and Infectious Diseases in Helsinki.
A few recent studies have shown that veterinarians seem to be at higher risk for methicillin-resistant Staphylococcus aureus (MRSA) carriage, likely because of their frequent contact with animals that can also carry MRSA. As part of the study at the ACVS conference, attendees provided nasal swabs (because the nose is the main site of MRSA carriage) on a voluntary basis, and filled out a questionnaire about various potential risk factors. MRSA was isolated from 17% of participants, an astounding number considering that in the general population only about 1-3% of people carry MRSA.
In previous studies of MRSA in veterinarians, including veterinary internists, equine general practitioners and swine veterinarians, it has been equine or swine veterinarians that most often harbour MRSA in their noses. Interestingly, in this study, there was no difference between equine and small animal (e.g. dog and cat) vets, which is perhaps due in part to the steady increase in MRSA carriage by dogs and cats internationally. This is one more piece of evidence indicating that MRSA exposure is an occupational risk for veterinary personnel. Colonized personnel may be more likely to develop MRSA infections, and are also at risk of transmitting MRSA to their patients (and possibly also their family members). This reminds us yet again of the need for good general infection control and hygiene practices in veterinary medicine.
It is truly astounding that MRSA colonization is so common in veterinarians. This is a consistent result among a few different studies now, and veterinarians may be one of the highest risk groups (if not the highest risk) for MRSA colonization. Why is this the case? Why is the prevalence not as high in human healthcare personnel? From where is the MRSA coming? From the patients presumably? How do we control it? What are the implications for the health of veterinary personnel and their families? These are just some of the many important but unanswered questions.
All this being said, you don’t need to (and shouldn’t) actually consider veterinary surgeons (or veterinarians in general) biohazardous, nor should you avoid using veterinary specialists because of concerns about MRSA. MRSA is a problem in veterinary medicine in both referral and general practices, and studies like this show the need for further research to determine why this is the case, as well as the need for general improvement in infection control in veterinary medicine.