RESEARCH ARTICLE MRSA Carriage in Community Outpatients: A Cross-Sectional Prevalence Study in a High- Density Livestock Farming Area along the Dutch-German Border

Objectives MRSA poses a considerable public health threat to the community. The objectives of this study were to assess the prevalence of MRSA carriage and determine factors that were associated with MRSA carriage among outpatients who had used antibiotics in the previous three months and who lived in a high-density livestock farming area along the Dutch-Ger-man border. Methods Cross-sectional prevalence study carried out between November 2011 and June 2012. Nasal swabs and questionnaires were collected in patients (>4 years) who had used antibi-otics in the previous three months from twelve Dutch General Practitioners (GPs), seven German GPs and two German outpatient urologists. To assess nasal carriage, swabs were analyzed using selective MRSA agars after broth enrichment. MRSA positive samples were spa typed. Results Data were collected from 513 GP outpatients in the Netherlands, 261 GP outpatients in Ger-many and 200 urologist outpatients in Germany. The overall prevalence of MRSA carriage was 0.8%, 1.1 % and 2.0%, respectively. In the GP outpatient populations, the prevalence was similar in both countries (0.8 % and 1.1%, respectively, p = 0.879), all spa types wer