Environmental contamination as a risk factor for intra-household Staphylococcus aureus transmission.
Environmental contamination as a risk factor for intra-household Staphylococcus aureus transmission.
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DOI：
10.1371/journal.pone.0049900
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Lowy FD
中科院分区：
文献类型：
--
作者：
Knox J;Uhlemann AC;Miller M;Hafer C;Vasquez G;Vavagiakis P;Shi Q;Lowy FD
家庭是公认的金黄色葡萄球菌社区储存库。本研究调查了家庭内S。金黄色葡萄球菌传播，包括环境污染的贡献。我们调查了家庭内部的S。金黄色葡萄球菌的传播，使用的多个成员家庭的样本，从社区为基础的病例对照研究，检查CA-MRSA感染的危险因素，在北方曼哈顿进行。在家访期间，索引受试者完成了一份问卷。所有同意的家庭成员都被擦拭，标准化的环境家居用品也被擦拭。拭子培养S。金黄色的对阳性分离株进行了进一步的分子表征。家庭内传播被定义为在两个或两个以上的家庭成员之间具有相同的菌株。多元逻辑回归用于确定传播的独立危险因素。我们招募了291个家庭：146个指标病例，145个指标对照和687个家庭接触者。大多数指数为西班牙裔（85%），低收入（74%）和女性（67%），平均年龄为31岁（范围1-79）。病例家庭和对照家庭的平均规模为4人。S.金黄色葡萄球菌在62%的家庭中定植，并在54%的家庭中污染环境。USA 300是主要的临床感染、定植和环境菌株。81个家庭有家庭内传播的证据：55个（38%）病例和26个（18%）对照家庭（P<0.01）。环境污染与定植或临床感染菌株（aOR：5.4 [2.9-10.3] P<0.01）和5岁以下儿童的存在（aOR：2.3 [1.2-4.5] P = 0.02）与传播独立相关。 在单独的多变量模型中，环境污染与病例（aOR 3.3，p<0.01）和对照家庭（aOR 27.2，p<0.01）之间的传播相关。在一个大型社区样本中，环境污染与定植或临床感染菌株的传播显著且独立相关。处理S.金黄色葡萄球菌感染，特别是在有多名感染成员的家庭中。
The household is a recognized community reservoir for Staphylococcus aureus. This study investigated potential risk factors for intra-household S. aureus transmission, including the contribution of environmental contamination. We investigated intra-household S. aureus transmission using a sample of multiple member households from a community-based case-control study examining risk factors for CA-MRSA infection conducted in Northern Manhattan. During a home visit, index subjects completed a questionnaire. All consenting household members were swabbed, as were standardized environmental household items. Swabs were cultured for S. aureus. Positive isolates underwent further molecular characterization. Intra-household transmission was defined as having identical strains among two or more household members. Multiple logistic regression was used to identify independent risk factors for transmission. We enrolled 291 households: 146 index cases, 145 index controls and 687 of their household contacts. The majority of indexes were Hispanic (85%), low income (74%), and female (67%), with a mean age of 31 (range 1–79). The average size of case and control households was 4 people. S. aureus colonized individuals in 62% of households and contaminated the environment in 54% of households. USA300 was the predominant clinical infection, colonizing and environmental strain. Eighty-one households had evidence of intra-household transmission: 55 (38%) case and 26 (18%) control households (P<.01). Environmental contamination with a colonizing or clinical infection strain (aOR: 5.4 [2.9–10.3] P<.01) and the presence of a child under 5 (aOR: 2.3 [1.2–4.5] P = .02) were independently associated with transmission. In separate multivariable models, environmental contamination was associated with transmission among case (aOR 3.3, p<.01) and control households (aOR 27.2, p<.01). Environmental contamination with a colonizing or clinical infection strain was significantly and independently associated with transmission in a large community-based sample. Environmental contamination should be considered when treating S. aureus infections, particularly among households with multiple infected members.
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影响因子：
4.5
作者：
Fritz SA;Camins BC;Eisenstein KA;Fritz JM;Epplin EK;Burnham CA;Dukes J;Storch GA
通讯作者：
Storch GA
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