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: 7744696
• 负责人: FRANKLIN D LOWY
• 金额: $ 63.44万
• 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/7744696
• 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; Recruitment Activity; Research Design; Research Methodology; Research Personnel; 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; public health relevance; social; transmission process

DESCRIPTION (provided by investigator): 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 application 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. PUBLIC HEALTH RELEVANCE There is minimal understanding of how community-associated methicillin-resistant S. aureus (CA-MRSA) spreads and subsequently become established within communities. The goals of this study are to: 1) identify the social network contacts as well as the nature of contacts of CA-MRSA infected subjects and the potential environmental reservoirs of CA-MRSA; 2) develop a mathematical model that predicts transmission pathways and potential intervention strategies within the community; and 3) define the role of adaptive genetic changes in "fitness" of CA-MRSA strains on transmission.

描述（研究人员提供）：抗生素抗生素的金黄色葡萄球菌感染现在越来越多地在社区中遇到。这些基于社区的感染，尤其是那些由于耐甲氧西林的金黄色葡萄球菌（MRSA）引起的感染，已经发生在没有通常的危险因素的组中。人们对这些菌株如何扩散并随后建立在社区中的建立有很少的了解。如果要设计干预措施以防止人口相关（CA）-MRSA分离株进行干预措施，这仍然是一个关键问题。这项研究将解决以下问题。 1。造成了哪些压力造成社区内CA-MRSA传播的途径？将确定哥伦比亚大学医学中心集水区域内CA-MRSA传播的模式，这是一个主要服务不足的移民人口。该研究将使用回顾性案例控制研究设计。 LNDEX案例具有记录的CA-MRSA感染和社区匹配的索引控制措施，将提供有关您和他们以Egentric网络成员的信息。网络信息将补充社区内CA-MRSA潜在储层（例如日托设施和学校）收集的数据。这些地点的受试者将被匿名采样，以通过CA-MRSA定植/感染。结果将用于创建个人，网络和社区参数的传输概率估算值。然后将开发数学模型来模拟社区内的传输途径，并研究可能用于防止CA-MRSA传播的潜在干预策略。 2。金黄色葡萄球菌的菌株在社区中会进化并更适合环境吗？我们假设CA-MRSA菌株适应其环境，并随着它们的传播而变得更加生态“适合”。人群不同亚组（例如，日托儿童）在社区中普遍存在的选定菌株将使用比较的总基因组测序进行遗传分析。可能会增强适应性的突变将使用参数（例如生长速率，遵守不同的组织表面）以及环境表面上的存活来筛选。然后，将对从社区收集的所有金黄色葡萄球菌菌株进行“健身”突变的屏幕。该申请研究了CA-MRSA在城市内部人口中的传播。我们最近完成的CDC研究表明，社区有兴趣并愿意参加这类调查。与美国其他社区不同，CA-MRSA直到最近才开始成为该社区的一种重要病原体，因此在CA-MRSA成为地方性之前，仍然可以进行传播研究。最后，这项研究是多种研究方法的创新整合，包括社交网络数据收集策略，分子流行病学，遗传菌株分析和数学模型，以解决这一紧迫问题。最终结果应该是对CA-MRSA传播的更全面的理解，以及在社区环境中最有可能成功的干预策略。公共卫生的相关性最少了解社区相关的耐甲氧西林金黄色葡萄球菌（CA-MRSA）如何传播，然后在社区内建立。这项研究的目标是 至：1）确定社交网络接触以及CA-MRSA感染受试者的联系的性质以及CA-MRSA的潜在环境库； 2）开发一个数学模型，以预测社区内部的传输途径和潜在的干预策略； 3）定义自适应遗传变化在CA-MRSA菌株“适应性”中的作用。