Staphylococcus aureus SPREAD (S. aureus Study of Prevalence Resistance and Environmental Dissemination)

金黄色葡萄球菌传播（金黄色葡萄球菌流行耐药性和环境传播研究）

• 批准号: 10366417
• 负责人: Michael Zdenek David
• 金额: $ 71.06万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10366417
• 关键词: Admission activity; Affect; Antibiotic Resistance; Antimicrobial Resistance; Area; Bacteria; Bacterial Infections; Bacteriophages; Characteristics; Code; Collection; Communities; DNA; Data; Data Collection; Detection; Disease Outbreaks; Distant; Drug resistance; Environment; Evolution; Frequencies; Future; Genes; Genetic; Genetic Markers; Goals; Hand; Health Personnel; Healthcare; Hospital Units; Hospitals; Human; Human body; Infection; Infection Control; Infectious Skin Diseases; Inpatients; Investigation; Link; Lung infections; Methicillin; Mobile Genetic Elements; Monobactams; Mucous Membrane; Nose; Nosocomial Infections; Obesity; Organ; Pathogenicity; Pathway interactions; Patients; Patients' Rooms; Pennsylvania; Persons; Plant Roots; Plasmids; Population; Prevalence Study; Preventive measure; Process; Resistance; Resolution; Risk; Risk Factors; Route; Sampling; Sepsis; Site; Skin; Staphylococcus aureus; Staphylococcus aureus infection; Testing; University Hospitals; Variant; Virulence; Virulence Factors; base; beta-Lactams; clinical risk; cohort; discrete data; genetic discrimination; genome sequencing; genomic data; health care settings; high risk; hospital bed; improved; methicillin resistant Staphylococcus aureus; microbial; neonate; pathogen; prevent; preventive intervention; resistance factors; resistant strain; trait; transmission process; whole genome

PROJECT SUMMARY Staphylococcus aureus is a bacterial species that causes infections of the skin, lungs, blood and internal organs. These infections can have their onset in the community or in the health care setting, including those caused by antimicrobial-resistant strains called methicillin-resistant S. aureus (MRSA). About 28-50% of all people are asymptomatic carriers of this species on their bodies. The interaction of S. aureus strains in the community and in hospitals has not been adequately studied. While we think that S. aureus can spread from person to person in hospitals, we are not sure how often that happens, if some strains spread more readily than others in the hospital, and how often infections result from the S. aureus bacteria that patients bring with them on their own bodies. Also, it is unclear how important fomites (inanimate objects) or the bodies of healthcare workers (HCWs) are as intermediate carriers in spreading S. aureus from patient to patient in the hospital. This study will be based on data from whole genome sequencing (WGS) of S. aureus collected in two units at the Hospital of the University of Pennsylvania (HUP). For 24 months, we will test all patients upon admission for S. aureus colonization of 4 body sites. For a subset of subjects colonized with S. aureus, we will test fomites in their hospital room for S. aureus. We will choose control patients who are not colonized with S. aureus on admission and test their room fomites to determine what the risk factors are for acquisition and spread of S. aureus in the hospital. Using WGS we will test all of the bacteria causing infections on the study units to see how often specific strains spread, and we will determine whether some genetic traits of S. aureus make them more likely to spread and/or more likely to cause infections. In addition, each month, we will test a sample of the noses and gloves of HCWs on study units to see if they carry S. aureus. We will test common areas of these units to see if fomites carry S. aureus. We will determine if any of the spreading S. aureus strains are found on HCWs or common-area fomites. We will examine all infecting S. aureus isolate genomes from the entire 850-bed HUP during an overlapping 2-year period to identify evidence for distant spread of S. aureus causing an infection. We hope to better understand the genetic markers of virulence and transmissibility in S. aureus. We will test the hypothesis that strains of S. aureus that spread develop a distinct collection of plasmids, which are mobile genetic elements coding for antibiotic resistance or virulence factors that S. aureus may or may not carry. With these results, we may be able to identify patients carrying high-risk S. aureus isolates and develop strategies to prevent the spread of this bacterium in the future.

项目摘要 金黄色葡萄球菌是一种细菌，可引起皮肤，肺，血液和 内脏。这些感染可以在社区或医疗保健中发作 环境，包括由抗菌抗菌菌株引起的称为耐甲氧西林的菌株。 金黄色（MRSA）。大约28-50％的人是该物种的无症状携带者 身体。金黄色葡萄球菌菌株在社区和医院的相互作用尚未 充分研究了。虽然我们认为金黄色葡萄球菌可以在 医院，我们不确定发生的频率，如果某些菌株比 医院中的其他人，以及因葡萄球菌细菌引起的感染频率 带着自己的身体随身携带。同样，尚不清楚Fomites多么重要（无生命 物体）或医疗保健工人的身体（HCWS）在传播中是中间载体。 金黄色葡萄球菌从病人到病人。这项研究将基于整体数据 金黄色葡萄球菌的基因组测序（WGS）在大学医院的两个单位中收集 宾夕法尼亚州（HUP）。在24个月的时间里，我们将在入院时测试所有患者 四个身体部位的定殖。对于用金黄色葡萄球菌殖民的受试者的一部分，我们将测试 在他们的医院里为金黄色葡萄球菌的福米特人。我们将选择不属于的患者 在入院时与金黄色葡萄球菌殖民并测试其房间的fomite，以确定风险 因素是在医院获得和金黄色葡萄球菌的获取和传播的因素。使用WGS我们将测试所有 引起研究单位感染的细菌，以查看特定菌株传播的频率，并且 我们将确定金黄色葡萄球菌的某些遗传特征是否使它们更有可能传播 和/或更可能引起感染。此外，我们每个月都会测试 HCW的鼻子和手套在研究单元上，以查看它们是否携带金黄色葡萄球菌。我们将测试普通 这些单元的区域以查看Fomites是否携带金黄色葡萄球菌。我们将确定是否扩散 金黄色葡萄球菌菌株在HCWS或普通面积的Fomites上发现。我们将检查所有感染S. 在整个850张床的HUP的2年期间，整个850张床HUP的金黄色金融基因组 确定金黄色葡萄球菌远处传播的证据，导致感染。我们希望更好 了解金黄色葡萄球菌中毒力和可传染性的遗传标记。我们将测试 假设散布的金黄色葡萄球菌菌株会产生独特的质粒集合， 是针对金黄色葡萄球菌的抗生素耐药性或毒力因子编码的移动遗传元素 可能会或可能不会携带。通过这些结果，我们可能能够识别出携带高风险的患者 S.金黄色葡萄球菌分离并制定策略以防止将来该细菌传播。