I recently gave a talk to a group here in Iowa City, emphasizing just how frequently we share microbes. It was a noontime talk over a nice lunch, and of course I discussed how basically we humans are hosts to all kinds of organisms, and analysis of our "extended microbiome" shows that we share not only with each other, but also with a large number of other species. We certainly do this with my particular organism of interest, Staphylococcus aureus. There are many reports in the literature showing where humans have apparently spread their strains of S. aureus to their pets (dogs, cats, hamsters)--and sometimes the pets have been nice enough to share it right back. My own research looks at S. aureus in pigs and the humans who care for them, and many studies have shown that a "pig" type of MRSA, dubbed sequence type 398 (ST398), can be transmitted from pig carriers to their human caretakers. The assumption has been that this is truly a "pig" strain, originating in swine, and has spread to humans (and other animals, including cattle, poultry, dogs and horses) from pig hosts, either directly or indirectly via contaminated meat products.
According to a new study (open access in mBio), it seems that there has been more sharing of ST398 than we'd realized. Led by Lance Price at TGEN (full disclosure--I'm a coauthor on the paper), his group analyzed 89 ST398 isolates from China, Europe, and North America, including isolates from humans and animals as well as both methicillin-susceptible and -resistant strains. Using whole genomic sequence typing, the evolutionary history of these isolates was reconstructed.
The findings throw the ST398 story a bit on its head. Instead of being a true pig strain, ST398 appears to have originated as a methicillin-susceptible human strain which was transferred into the pig population, picked up antibiotic resistance genes (including resistance to methicillin and tetracyclines), and then has been passed back to farmers as more resistant organisms. Some prophages were also gained or lost along the way, probably due to selection by host factors.
This also suggests that there is still likely a low level of "native human" ST398 circulating in people. There have been a few case reports of ST398 colonization and/or infection in people without any known livestock contact. Some of these have been resistant to methicillin and/or tetracycline, which are more frequently associated with livestock-adapted strains. Are these truly "human" strains which aren't involved in livestock at all, or are these ST398 findings in people lacking livestock contact still due to some livestock exposure along the chain of transmission (farmer neighbors? Transmission via food?) We still don't know, but carrying out more of this WGST will give us better targets in order to be able to differentiate true "human" ST398 strains from those that have been hanging out in animals, and then transmitted back to people.
Now, for long-time science blog readers, this story may sound a bit familiar. Indeed, it looks like ST398 has taken a very similar path to that of another animal-associated S. aureus strain, ST5. As Ed Yong described back in 2009, humans are also the ultimate origin of a "chicken" type of S. aureus ST5, which spread around the world in broiler chicken flocks. In Ed's article, the first author of the chicken ST5 paper, Bethan Lowder, notes that the change in chicken farming from small farms to multinational corporations likely aided the spread of this organism--and the exact same thing has happened with pig farming.
One difference between the two is that ST5 causes disease in chickens, whereas ST398 seems to be a very rare cause of illness in pigs. This is likely one reason that ST398 in pigs went undetected until relatively recently--it's simply not much of an economic issue for pig producers, whereas in chickens, S. aureus can cause several nasty diseases (such as bumblefoot and BCO) leading to animal loss (and thus, less money for the farmer).
So, where do we go from here? Clearly studies like this show the utility of using WGST to examine the evolution and spread of these strains. If you look at how spa types are distributed throughout the tree, you can see that those alone don't tell you much about where the strain came from, or if it's fully "human" or a pig-adapted lineage. Ideally, a set of simple markers could be found to distinguish ancestral human strains from livestock strains (as methicillin-sensitive ST398 can also be found in pigs, so methicillin resistance alone isn't enough of an indicator that it's a "pig" strain). We'll be working on this in ST398 and other strains we see being shared between animals and humans, in order to better understand this generous sharing we're doing amongst species.
Lance B. Price, Marc Stegger, Henrik Hasman, Maliha Aziz, Jesper Larsen, Paal Skytt Andersen, Talima Pearson, Andrew E. Waters, Jeffrey T. Foster, James Schupp, John Gillece, Elizabeth Driebe, Cindy M. Liua, Burkhard Springer, Irena Zdovc, Antonio Battisti, Alessia Franco, Jacek Å»mudzki, Stefan Schwarz, Patrick Butayej, Eric Jouy, Constanca Pomba, M. ConcepciÃ³n Porrero, Raymond Ruimy, Tara C. Smith, D. Ashley Robinson, J. Scott Weese, Carmen Sofia Arriola, Fangyou Yu, Frederic Laurent, Paul Keima,, Robert Skov, & Frank M. Aarestrup (2012). Staphylococcus aureus CC398: Host Adaptation and Emergence of Methicillin Resistance in Livestock mBio, 3 (1), 305-311 : 10.1128/mBio.00305-11
Great article! New research says you can't simply say: MRSA or "Pig MRSA" is caused by the overuse of antibiotics in the pig industry. It seems to be more complicated.
Well, not exactly. Yes, it is more complicated, but note that resistance to several classes of antibiotics were acquired in pigs--so I think the overuse of antibiotics in ag is certainly a large factor in strains of ST398 that are antibiotic-resistant.
Hi Tara, I saw this yesterday and forwarded it to my EID editor in hopes of replacing ref. #10. I see now why one of the reviewers suggested referencing it. It would appear that the MSSA ST398 strains described in the EID paper may be 'ancestral', circulating at low levels in humans as you describe...
Tara, I was reading, "We Beasties," and Kevin was talking about nominations for some sort of science blogging award. He does have some writing I'd like to vote for/nominate. But, I'd like to point out this piece seems pretty solid to me. As well as the one on MRSA in pork products and "antibiotic" free label.
Was just listening to the Quirks & Quarks podcast. Heard this familiar story. Didn't hear Bob say "Tara Smith" until the end. It's your 9:06 of fame?
I enjoyed the interview on Quirks & Quarks. Sounds like very promising research.
You mentioned animal husbandry practices in Europe but have you seen some of the innovations at places like Polyface Farms in Virginia? They combine animals like pigs and cows or chickens and rabbits to help create less mono-culture environments that help reduce disease. They also move the pens around to spread out the manure around the land and keep a healthier environment for the animals.