Risk Factors for Spread of Staphylococcus aureus in Prisons.

金黄色葡萄球菌在监狱中传播的危险因素。

• 批准号: 8305996
• 负责人: FRANKLIN D LOWY
• 金额: $ 77.02万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-15 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8305996
• 关键词: Address; Admission activity; Athletic; Attention; Characteristics; Child; Clinical; Collaborations; Communities; Comorbidity; Coupled; Cross-Sectional Studies; Crowding; DNA Fingerprinting; Data; Databases; Development; Disease Outbreaks; Drug usage; Environment; Environmental Exposure; Epidemiology; Geographic Locations; Goals; HIV Infections; Health; Healthcare; Hospitals; Human Resources; Imprisonment; Incidence; Infection; Injection of therapeutic agent; Intake; Intervention; Interview; Jail; Letters; Link; Measures; Medical; Military Personnel; Modality; Molecular; Movement; Native Americans; Nature; Nested Case-Control Study; New York; Pattern; Population; Prevalence; Principal Investigator; Prisoner; Prisons; Public Health; Publications; Recording of previous events; Records; Recruitment Activity; Research; Research Personnel; Risk; Risk Factors; Role; Services; Site; Staphylococcal Infections; Staphylococcus aureus; System; Techniques; Testing; Time; United States; base; community setting; high risk; methicillin resistant Staphylococcus aureus; population based; prevent; programs; therapy design; transmission process

DESCRIPTION (provided by applicant): The dramatic rise in community-based S. aureus infections, many due to methicillin resistant S. aureus (MRSA), has become an important public health problem. This proposal will focus on prisoners, a high-risk group that has received limited attention. Prior studies have examined prison outbreaks without addressing several critical questions. These questions include the role of S. aureus colonization in the prison environment, how S. aureus is introduced into prisons and what the modalities of S. aureus persistence and transmission are in the nonepidemic prison setting. Our long term goal is to develop strategies that will prevent and control transmission of S. aureus within the prison system as well as in similar crowded environments. Our specific aims are the following. 1) We will identify patterns of S. aureus strain transmission within the prison. A cross-sectional analysis of prisoners will be performed to determine the prevalence of S. aureus colonization and/or infection. The role of assigned activities, environmental exposures, prisoner contacts and their spatial proximity in S. aureus transmission will be examined. Bacterial factors associated with the predominance of particular clones of S. aureus will be examined. 2) We will determine the factors associated with the development of clinical infections within the prison. A subset of inmates with culture proven S. aureus infections will be studied in a nested case-control study to determine factors contributing to symptomatic infection in the prison. 3) We will identify risk factors associated with colonization and/or infection with S. aureus at prisoner intake and at release. New prison inmates will be interviewed cultured and their prison/jail records reviewed. Risk factors predictive of S. aureus colonization/infection on arrival will be identified. Because >600,000 prisoners are released into the community each year, they can serve as an important reservoir for staphylococcal transmission. Therefore, S. aureus colonization at the time of release will also be assessed and factors contributing to colonization at release will be examined. This proposal provides an unparalleled opportunity to examine transmission of S. aureus (including MRSA) within the prison setting. The ongoing collaboration of prison personnel with the investigators is unique as is the integration of methodological approaches that will allow us to examine the roles of networks coupled with spatia characteristics in prisons. PUBLIC HEALTH RELEVANCE: This proposal will focus on prisoners, a group at particularly high risk for these infections. The study will investigate how S. aureus is transmitted in this population.

描述（由申请人提供）：社区金黄色葡萄球菌感染急剧增加，其中许多是由耐甲氧西林金黄色葡萄球菌（MRSA）引起的，已成为一个重要的公共卫生问题。该提案将重点关注囚犯这一受到有限关注的高风险群体。先前的研究考察了监狱的疫情爆发，但没有解决几个关键问题。这些问题包括金黄色葡萄球菌定植在监狱环境中的作用、金黄色葡萄球菌如何被引入监狱以及金黄色葡萄球菌在非流行性监狱环境中的持续存在和传播方式是什么。我们的长期目标是制定预防和控制监狱系统内以及类似拥挤环境中金黄色葡萄球菌传播的策略。我们的具体目标如下。 1) 我们将确定监狱内金黄色葡萄球菌菌株的传播模式。对囚犯进行横断面分析以确定金黄色葡萄球菌定植和/或感染的流行率。将审查指定活动、环境暴露、囚犯接触及其空间邻近性在金黄色葡萄球菌传播中的作用。将检查与金黄色葡萄球菌特定克隆的优势相关的细菌因素。 2) 我们将确定与监狱内发生临床感染相关的因素。将在巢式病例对照研究中对培养证实金黄色葡萄球菌感染的囚犯子集进行研究，以确定导致监狱内出现症状感染的因素。 3) 我们将确定囚犯入狱和释放时与金黄色葡萄球菌定植和/或感染相关的风险因素。新监狱囚犯将接受文化访谈，并审查他们的监狱记录。将确定预测金黄色葡萄球菌抵达时定植/感染的风险因素。由于每年有超过 600,000 名囚犯被释放到社区，因此他们可以成为葡萄球菌传播的重要储存库。因此，还将评估释放时金黄色葡萄球菌的定植，并检查有助于释放时定植的因素。该提案为检查监狱环境中金黄色葡萄球菌（包括 MRSA）的传播提供了无与伦比的机会。监狱工作人员与调查人员正在进行的合作是独一无二的，因为方法论方法的整合将使我们能够检查网络的作用以及监狱中的空间特征。公共卫生相关性：该提案将重点关注囚犯，这是感染这些感染的高风险群体。该研究将调查金黄色葡萄球菌如何在该人群中传播。