Project #1: Do Pathogen Genotypes, Carriage, and Social Network Differences Lead to Health Disparities in MRSA/MSSA Infections?

项目摘要 卫生保健相关（HA）金黄色葡萄球菌感染正在下降，但仍然很常见。相反地， 由于控制机制不足，与社区有关的感染率没有下降， 在社区环境中传播。西班牙裔美国人感染的风险比非西班牙裔美国人低 白人，而美洲印第安人面临感染的风险增加。造成这种差异的根本原因是 未知我们的长期目标是使用基于经验证据的风险信息， 传播的信息干预策略，减少S。金黄色葡萄球菌在社区传播。我们 近期目标是确定国家趋势是否反映在尤马的不同族裔群体中， 亚利桑那州维斯感染率和无症状携带。我们还将确定临床菌株是否 代表社区携带菌株，而不是由于少数高度适应的谱系的出现。给定 由于种族群体之间的旅行和居住模式，社会互动存在巨大差异，我们还 目的是确定社会关系和互动对S的作用。金黄色葡萄球菌传播，无论是作为 风险或保护因素。理由是我们将了解这种健康的根本原因 差异和获得进一步的见解的重要组成部分，S。金黄色葡萄球菌传播：社区传播， 病原体基因型和社会互动的影响。 具体目标#1。我们将描述S。金黄色葡萄球菌感染和携带率，并比较循环 病原体基因型与从当地临床标本中分离的疾病相关的基因型， 全职和兼职居民群体，以及西班牙裔和非西班牙裔白色群体。整个 来自社区采样的基因组将与来自临床样本的基因组进行遗传学比较， 确定临床病原体基因型的多样性是否代表社区基因型。我们预计 为了找到证据证明病原体种群在这些群体中没有差异，这表明病原体 基因型不能解释S.金黄色葡萄球菌感染 具体目标#2。我们将确定和测试基于社会网络和社会决定因素的风险 传播的因素。金黄色。在招募参与者时，我们将收集数据， 社会“接触”群体。我们将使用健康的社会决定因素和社会网络变量（包括自我- 中心的和关系的），以确定在何种程度上社会关系可以有助于理解S。 金黄色葡萄球菌传播1）询问参与者的问题，旨在量化社会中的身体接触 组，2）将其鼻、咽和手微生物组作为接触的独立估计值 和社会的接近导致的传播，3）和比较进化的物种， S的相关性。金黄色葡萄球菌阳性样本与参与者之间的测量或估计接触水平。 !

PROJECT SUMMARY Healthcare-associated (HA) Staphylococcus aureus infections are declining but remain common. Conversely, rates of community-associated infections have not decreased due to the inadequacy of mechanisms to control transmission in a community setting. Hispanic Americans have a lower risk of infection than non-Hispanic whites, while American Indians face an increased risk for infections. The underlying causes of this disparity are unknown. Our long term objective is to use risk-based information founded upon empirical evidence of transmission to inform intervention strategies that reduce S. aureus transmission in the community. Our immediate goals are to determine whether national trends are reflected within different ethnic groups in Yuma, Arizona vis à vis infection rates and asymptomatic carriage. We will also determine if clinical strains are representative of community-carriage strains and not due to the emergence of a few, highly fit lineages. Given the broad differences in social interactions due to travel and residency patterns among ethnic groups, we also aim to determine the role that social relationships and interactions have on S. aureus transmission, either as risk or protective factors. The rationale is that we will gain an understanding of underlying causes of this health disparity and gain further insights into important components of S. aureus transmission: community carriage, pathogen genotypes, and the impact of social interactions. Specific Aim #1. We will characterize S. aureus infection and carriage rates and compare circulating pathogen genotypes with those associated with disease isolated from local clinical specimens across full- and part-time resident groups, and across Hispanic and Non-Hispanic White ethnic groups. Whole genomes from community sampling will be phylogenetically compared to those from clinical samples to determine if the diversity of clinical pathogen genotypes is representative of community genotypes. We expect to find evidence that pathogen populations do not differ among these groups, suggesting that pathogen genotypes do not explain ethnic based disparities in S. aureus infections. Specific Aim #2. We will determine and test social network- and social determinants-based risk factors for transmission of S. aureus. While enrolling participants, we will collect data that will define local social “contact” groups. We will use social determinants of health and social network variables (both ego- centric and relational) to determine the extent to which social relationships can contribute to understanding S. aureus transmission by 1) asking participants questions designed to quantify physical contact within a social group, 2) characterizing their nasal, pharyngeal, and hand microbiome as independent estimators of contact and social proximity resulting in transmission of commensal species, 3) and by comparing the evolutionary relatedness of S. aureus positive samples with the measured or estimated level of contact among participants. !