Social Networks of S. aureus Carriage Among Drug Users

描述（由申请人提供）：金黄色葡萄球菌是吸毒者细菌感染的最常见原因，并且越来越被认为是艾滋病患者危及生命的疾病的主要原因。吸毒者和艾滋病毒感染者都增加了金黄色葡萄球菌定植和随后感染的发生率。关于金黄色葡萄球菌鼻腔定植的生物学或在任何已知高危人群中定植率增加的基础知之甚少。在一项对活跃吸毒者的社区研究中，我们发现了几个生物联系网络，这些网络的受试者定植了密切相关的金黄色葡萄球菌菌株。通过脉冲场凝胶电泳（PFGE）建立的菌株的生物学联系首次确定了这些网络。这项研究证明了药物使用环境，“可卡因屋”和金黄色葡萄球菌的生物学联系网络之间的关系。本提案的总体目标是确定金黄色葡萄球菌在药物使用风险网络中的传播程度、模式和机制。我们的具体目标如下。1. 建立金黄色葡萄球菌在药物使用网络中定植的基线分布。2. 探讨金黄色葡萄球菌定殖的流行程度和菌株相似性与药物使用网络结构、风险行为和药物使用环境特征的关联程度。3. 检查诸如艾滋病毒状况等辅助因素是否影响定植。4. 确定药物使用用具对金黄色葡萄球菌传播的贡献。5. 使用PFGE和多位点序列分型分析葡萄球菌分离株，以确定菌株身份和菌株之间的亲缘程度，将其与国际和区域菌株数据库相关联，补充通过生物连锁数据访谈确定的社会网络联系，并确定哪种分型工具在这种情况下最有用。6. 使用分型工具生成的菌株概况来确定赋予这些菌株生态优势的毒力决定因素，使它们能够定植，抵抗抗生素并在受试者之间传播。目前的研究利用了米勒博士先前在布鲁克林贝德福德史岱文森区的女性吸毒者及其网络成员的队列。这将使这项调查迅速融入到她正在进行的研究中。

DESCRIPTION (provided by applicant): Staphylococcus aureus is the single most common cause of bacterial infections among drug users and is increasingly recognized as a major cause of life-threatening disease in patients with AIDS. Both drug users and HIV-infected individuals have an increased incidence of colonization and subsequent infection with S. aureus. Little is known about the biology of S. aureus nasal colonization or the basis for the increased rate of colonization among any of the known high-risk groups. In a community study of active drug users, we found several biologically linked networks of subjects colonized with closely related strains of S. aureus. The biologic linkage of the strains, established by pulsed field gel electrophoresis (PFGE), first identified these networks. This study demonstrated a relationship between the drug use setting, a "crack house", and the biologically linked networks of S. aureus. The overall goal of this proposal is to define the extent, patterns and mechanisms of S. aureus transmission among drug use risk networks. Our specific aims are the following. 1. Establish the baseline distribution of S. aureus colonization in drug use networks. 2. Explore the extent to which the prevalence and strain similarity of S. aureus colonization are associated with the structure of drug use networks, risk behaviors and features of drug use settings. 3. Examine whether co-factors, such as HIV status influences colonization. 4. Determine the contribution of drug use paraphernalia to the transmission of S. aureus. 5. Analyze staphylococcal isolates using PFGE and multilocus sequence typing, in order to define strain identity and the degree of relatedness among isolates, correlate them with international and regional strain databases, supplement social network linkages identified through interview with biologic linkage data and determine which typing tool is most useful in this setting. 6. Use the strain profiles generated by the typing tools to identify virulence determinants that confer an ecologic advantage to these strains, enabling them to colonize, resist antibiotics and spread among subjects. The present study takes advantage of Dr. Miller's preexistent cohort of women drug users and their network members in the Bedford Stuyvesant section of Brooklyn. This will allow for the rapid integration of this investigation into her ongoing study.