Modeling of S. aureus Transmission in Northern Manhattan.

曼哈顿北部金黄色葡萄球菌传播模型。

• 批准号: 8197322
• 负责人: FRANKLIN D LOWY
• 金额: $ 66.88万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-12-15 至 2013-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8197322
• 关键词: Academic Medical Centers; Accounting; Address; Adherence; Antibiotic Resistance; Athletic; Case-Control Studies; Catchment Area; Cell Survival; Centers for Disease Control and Prevention (U.S.); Child; Clinic; Communities; Community Networks; Controlled Study; Data; Data Collection; Disease; Disease Outbreaks; Environment; Epidemic; Epidemiologic Methods; Epidemiology; Epithelial Cells; Fibronectins; Goals; Growth; Healthcare; Immigrant; Individual; Infection; Information Networks; Intervention; Invaded; Investigation; Keratin; Life; Link; Measures; Methicillin Resistance; Military Personnel; Mobile Genetic Elements; Modeling; Molecular; Molecular Epidemiology; Mutation; Native Americans; Nature; Pathway interactions; Pattern; Population; Prevalence; Prisons; Probability; Research Design; Research Methodology; Risk; Risk Factors; Role; Sampling; Schools; Sexually Transmitted Diseases; Simulate; Site; Site-Directed Mutagenesis; Social Network; Sports; Staphylococcus aureus; Subgroup; Surface; Tissues; United States; base; community setting; comparative; defined contribution; design; fitness; genetic analysis; genetic strain; genome sequencing; in vitro Assay; indexing; inner city; innovation; interest; mathematical model; member; methicillin resistant Staphylococcus aureus; pathogen; pressure; prevent; social; transmission process

Antibiotic-resistant S. aureus infections are now increasingly encountered in the community. These community-based infections, especially those due to methicillin-resistant S. aureus (MRSA), have occurred in groups without the usual risk factors. There is minimal understanding of how these strains spread and subsequently become established within communities. This remains a critical issue if interventions are to be designed to prevent population level dissemination of community-associated (CA)-MRSA isolates. This study will address the following questions. 1. What pressures are responsible for the pathways of CA-MRSA spread within the community? Patterns of CA-MRSA transmission within the Columbia University Medical Center catchment area, a largely underserved immigrant population, will be identified. The study will use a retrospective, case control study design. lndex cases with a documented CA-MRSA infection and community matched index controls will provide information on both themselves and their egocentric network members. Network information will be supplemented with data collected from potential reservoirs of CA-MRSA within the community (e.g., daycare facilities and schools). Subjects at these sites will be anonymously sampled for colonization/infection with CA-MRSA. The results will be used to create estimates of transmission probabilities for individual, network and community parameters. A mathematical model will then be developed to simulate transmission pathways within the community, as well as investigate potential intervention strategies that might be used to prevent CA-MRSA transmission. 2. Do strains of S. aureus evolve in the community and become more adapted to the environment? We hypothesize that CA-MRSA strains adapt to their environment and become more ecologically "fit" as they spread. Selected strains prevalent in the community among different subgroups of the population (e.g., children at daycare) will undergo genetic analysis using comparative total genome sequencing. Mutations that might enhance fitness will be screened using parameters such as growth rate, adherence to different tissue surfaces and survival on environmental surfaces. Screens for the "fitness" mutations will then be carried out on all S. aureus strains collected from the community. This proposal examines the spread of CA-MRSA in an inner city population. Our recently completed CDC study demonstrated that the community is interested and willing to participate in these types of investigations. Unlike other communities in the United States, CA-MRSA has only recently begun to emerge as a prominent pathogen in this community so that transmission studies are still possible, before CA-MRSA becomes endemic. Finally, this investigation is an innovative integration of diverse research methods including social network data collection strategies, molecular epidemiology, genetic strain analysis and mathematical modeling to address this pressing issue. The end result should be a more comprehensive understanding of CA-MRSA transmission and the intervention strategies that are most likely to be successful in a community setting.

现在社区中越来越多地遇到抗生素耐药性金黄色葡萄球菌感染。这些 社区感染，特别是由耐甲氧西林金黄色葡萄球菌 (MRSA) 引起的感染，已发生在 没有常见危险因素的群体。对这些菌株如何传播和传播的了解甚少 随后在社区内建立起来。如果要采取干预措施，这仍然是一个关键问题 旨在防止社区相关 (CA)-MRSA 分离株在人群中传播。这项研究 将解决以下问题。 1. CA-MRSA 传播途径受哪些压力影响 在社区内？哥伦比亚大学医学中心内 CA-MRSA 传播模式 将确定一个主要是服务不足的移民人口的集水区。该研究将使用一个 回顾性病例对照研究设计。记录有 CA-MRSA 感染的病例和社区索引 匹配的索引控制将提供有关其自身及其以自我为中心的网络成员的信息。 网络信息将得到从 CA-MRSA 潜在储存库收集的数据的补充。 社区（例如日托设施和学校）。这些站点的受试者将被匿名采样 CA-MRSA 定植/感染。结果将用于创建传输概率的估计 个人、网络和社区参数。然后将开发一个数学模型来模拟 社区内的传播途径，并调查可能的潜在干预策略 用于防止 CA-MRSA 传播。 2. 金黄色葡萄球菌菌株是否在群落中进化并成为 更适应环境？我们假设 CA-MRSA 菌株适应其环境并 随着它们的传播，变得更加生态“适应”。选定的在不同社区中流行的菌株 人口亚组（例如，日托所的儿童）将使用比较总数进行遗传分析 基因组测序。将使用生长等参数筛选可能增强适应性的突变 速率、对不同组织表面的粘附以及在环境表面上的存活。 “健身”屏幕 然后将对从社区收集的所有金黄色葡萄球菌菌株进行突变。 该提案研究了 CA-MRSA 在市中心人口中的传播情况。我们最近完成的疾病预防控制中心 研究表明，社区有兴趣并愿意参与此类调查。 与美国其他社区不同，CA-MRSA 最近才开始成为一种重要的病毒 在 CA-MRSA 成为该群体中的病原体之前，仍然可以进行传播研究 流行的。最后，这项调查是包括社会研究方法在内的多种研究方法的创新整合。 网络数据收集策略、分子流行病学、遗传菌株分析和数学建模 来解决这个紧迫的问题。最终结果应该是对CA-MRSA有更全面的了解 传播和最有可能在社区环境中成功的干预策略。