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）

基本信息

批准号：
10655277
负责人：
Michael Zdenek David
金额：
$ 73.92万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
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/10655277
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 Environment Evolution Frequencies Future Genes Genetic Genetic Markers Goals Hand Health Personnel Healthcare Hospital Units Hospitalization Hospitals Human Human body Individual Infection Infection Control Infectious Skin Diseases Inpatients Investigation Link Lung infections Methicillin Mobile Genetic Elements Mucous Membrane Nose Nosocomial Infections Obesity Organ Pathogenicity Pathway interactions Patients Patients&apos Rooms Pennsylvania Persons Plasmids Population Predisposition 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 acquired drug resistance acquired factor 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

项目摘要

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.

项目概要金黄色葡萄球菌是一种细菌，可引起皮肤、肺部、血液和内脏器官。这些感染可能发生在社区或医疗保健场所环境，包括由称为耐甲氧西林链球菌的抗菌菌株引起的环境。金黄色葡萄球菌（MRSA）。大约 28-50% 的人是该物种的无症状携带者尸体。金黄色葡萄球菌菌株在社区和医院中的相互作用尚未得到证实充分研究。虽然我们认为金黄色葡萄球菌可以在人与人之间传播医院，我们不确定这种情况发生的频率，是否某些菌株比其他菌株更容易传播医院中的其他人，以及患者感染金黄色葡萄球菌的频率带着他们自己的身体。此外，尚不清楚污染物（无生命的物体）或医护人员（HCW）的身体是传播金黄色葡萄球菌的中间载体。金黄色葡萄球菌在医院里从一个病人传到另一个病人。这项研究将基于整个数据大学医院两个单位收集的金黄色葡萄球菌基因组测序（WGS）宾夕法尼亚州 (HUP)。在 24 个月的时间里，我们将对所有患者入院时进行金黄色葡萄球菌检测 4 个身体部位的定殖。对于金黄色葡萄球菌定植的受试者子集，我们将测试他们的病房里有金黄色葡萄球菌污染物。我们将选择不属于对照组的患者入院时感染金黄色葡萄球菌，并测试他们的房间污染物以确定风险因素是金黄色葡萄球菌在医院内的获得和传播。我们将使用 WGS 测试所有在研究单位中引起感染的细菌，以了解特定菌株的传播频率，以及我们将确定金黄色葡萄球菌的某些遗传特征是否使其更有可能传播和/或更可能引起感染。此外，每个月我们都会测试一个样本检查研究单位医护人员的鼻子和手套，看看他们是否携带金黄色葡萄球菌。我们将测试常见的检查这些单位的区域，看看污染物是否携带金黄色葡萄球菌。我们将确定是否有任何传播金黄色葡萄球菌菌株存在于医护人员或公共区域污染物中。我们将检查所有感染 S. 金黄色葡萄球菌在重叠的 2 年时间内从整个 850 个床位的 HUP 中分离出基因组，确定金黄色葡萄球菌远距离传播导致感染的证据。我们希望能够更好了解金黄色葡萄球菌毒力和传播性的遗传标记。我们将测试假设传播的金黄色葡萄球菌菌株产生了独特的质粒集合，是编码金黄色葡萄球菌抗生素耐药性或毒力因子的可移动遗传元件可以携带也可以不携带。通过这些结果，我们也许能够识别出携带高风险的患者金黄色葡萄球菌分离并制定策略以防止这种细菌在未来传播。