| Published Articles 
                    Preventing Introduction of Livestock Associated MRSA in a Pig Population – Benefits, Costs, and Knowledge Gaps from the Swedish Perspective (published i PLoS One, May 2015)
                
                    
 
                Authors: 
                
            
           Sören Höjgård 
           
           Olov Aspevall 
           
           Björn Bengtsson 
           
           Sara Haeggman 
           
           Maria Lindberg 
           
           Kristina Mieziewski 
           
           Svante Nilsson 
           
           Helle Ericsson Unnerstad 
           
           Diana Viske 
           
           Helene Wahlström 
           
           
                     
 Antibiotic resistance is a growing concern in human, as well as in veterinary medicine. Part of the problem concerns how to respond to the risk presented by animal reservoirs of resistant bacteria with the potential of spreading to humans. One example is livestock associated methicillin-resistant Staphylococcus aureus (LA-MRSA). In countries where LA-MRSA is endemic in the pig population, people in contact with pigs have a higher risk of being colonised with LA-MRSA, and persons from this group are subjected to precautionary measures when visiting health care facilities. In the present study, it is assumed that, if LA-MRSA was introduced to the Swedish pig population, the prevalence in the risk groups would be the same as in Denmark or the Netherlands (two countries with low human prevalence that have implemented measures to detect, trace and isolate human LA-MRSA cases and, therefore, have comprehensive data with good coverage regarding prevalence of LA-MRSA), and that similar interventions would be taken in Swedish health care facilities. It is also assumed that the Swedish pig population is free of MRSA or that the prevalence is very low. We analyse if it would be efficient for Sweden to prevent its introduction by testing imported live breeding pigs. Given that quarantining and testing at import will prevent introduction to the pig population, the study shows that the preventive measures may indeed generate a societal net benefit. Benefits are estimated to be between € 870 720 and € 1 233 511, and costs to € 211 129. Still, due to gaps in knowledge, the results should be confirmed when more information become available. | 
        
     
    
    
Authors:
        
            
           
                Sören Höjgård
               
           
           
           
           
           
                Olov Aspevall
               
           
           
           
           
           
                Björn Bengtsson
               
           
           
           
           
           
                Sara Haeggman
               
           
           
           
           
           
                Maria Lindberg
               
           
           
           
           
           
                Kristina Mieziewski
               
           
           
           
           
           
                Svante Nilsson
               
           
           
           
           
           
                Helle Ericsson Unnerstad
               
           
           
           
           
           
                Diana Viske
               
           
           
           
           
           
                Helene Wahlström