動物養殖場所，金黃色葡萄球菌污染與工作人員暴露

Contamination of Staphylococcus aureus in Animal Feeding Farms and Worker Exposure

暴露於金黃色葡萄球菌可引發致死性肺炎與中毒性休克。本研究透過回顧近期國際學術文獻，彙整各類家禽家畜養殖場所工作人員、飼養動物以及工作環境內金黃色葡萄球菌的檢出情形。結果顯示，工作人員鼻部遭金黃色葡萄球菌移生之陽性率為0∼63%；其中，非洲、中美洲以及飼養羊群與牛隻的歐洲工作場域，工作者鼻腔內金黃色葡萄球菌移生比例有較高現象，部分地區養豬場工作人員的陽性率亦超過三成。對飼養的動物而言，鼻腔亦是金黃色葡萄球菌容易移生與繁殖之處，且豬與羊隻鼻腔內金黃色葡萄球菌之陽性率有高於牛隻之情形。除鼻腔外，飼養動物的皮膚、口腔、乳腺、腸道以及排出的糞便中亦可檢出金黃色葡萄球菌，其中皮膚與口腔較直腸容易檢出此菌；除檢出部位外，動物陽性率也呈現地域間的不同，以美國、奈及利亞以及位處南歐之義大利及希臘之陽性率較高。環境檢測數據則顯示，禽畜舍的圍欄、地板、各類儀器表面、以及在土壤、廢水、飲用水、飼料與空氣中，均可檢測出活性金黃色葡萄球菌。工作人員可經由呼吸吸入或手部接觸這些環境介質，衍生職業暴露與病原菌感染的可能。文獻顯示，養豬從業者與家禽飼養人員具有職業性金黃色葡萄球菌移生鼻腔的顯著風險，且與其工作場域飼養的家禽家畜數量、個人工作年資以及工作內容（如：近距離接觸動物從事豬隻清洗與餵食、接觸禽舍糞肥）等有關。本研究結果可提供未來於養殖動物場所規劃採樣分析策略以及介入管理控制措施之參考，用以執行職場環境監測及維護工作者與飼養動物的健康，透過促進職業衛生及避免牲畜或相關產品損失，創造產業經濟與職場健康雙贏局面。

"Exposure to Staphylococcus aureus may lead to lethal pneumonia and toxic shock syndrome. This study provides the information of S. aureus detected in various kinds of animal feeding farms via the article review. Results show that the positive rate of S. aureus colonized in the nose of the personnel working in animal farms ranged between 0% and 63%, with a higher detection rate in Africa, Central America, and in European sheep and cattle farms. The positive rate of S. aureus in workers of a certain pig farms also exceeded 30%. S. aureus also colonized in the nasal cavity of animals, with a higher positive rate of S. aureus in pigs and sheep than that of cattle. In addition to the nasal cavity, S. aureus was also detected in the skin, mouth, breast, intestine and excrement of the animals. The positive rate of S. aureus in animal noses differed between regions with more frequently detected in the United States, Nigeria, Italy and Greece. S. aureus was also detected in the enclosures, floors, surfaces of various instruments, and in soil, wastewater, drinking water, feed and air. Workers may occupationally expose to S. aureus via inhalation or touch those environmental media, leading to potential infection. The literature has shown that pig farmers and poultry breeders possess a significant risk of occupational S. aureus colonization. Such risk is related to the number of poultry and livestock raised, personal working years and work content (i.e., close contact with animals to engage in pig cleaning/feeding, and contact with poultry manure). The results of this study can provide the important information for future planning/conducting the sampling and analysis strategy and management and intervention measures in animal farms. By helping promote occupational hygiene and avoiding livestock or related product losses, it is expected that a win-win situation for economic development and occupational health can be achieved."