MRSA Colonization and Control in the Cook County Jail - R01

描述(申请人提供)：这个为期3年的项目的目标是控制社区相关的耐甲氧西林金黄色葡萄球菌(CA-MRSA)在芝加哥库克县监狱的传播。CA-MRSA是一种在健康人群中迅速传播的细菌，在该国许多地区成为一种流行病。耐甲氧西林金黄色葡萄球菌引起的感染很难控制，成本也很高，因为青霉素和类似的药物不能用来治疗它们。社区中的许多人都没有症状地被MRSA殖民。美国监狱和监狱爆发了MRSA感染，在库克县监狱很常见。我们担心监狱可能成为MRSA快速传播的场所，部分原因是CA-MRSA正在成为芝加哥市中心的地方病。我们将研究耐甲氧西林金黄色葡萄球菌在监狱中的传播情况，以更好地了解细菌在监狱中如何在人与人之间传播，以及我们如何防止它们的传播。所有被要求参加的被拘留者必须在知情的情况下同意这样做；他们的隐私将受到仔细保护。监狱中的17个物体和表面将首先进行MRSA污染采样。我们将测试3种消毒剂对我们识别的两个最常见的污染表面或物体进行去污的效果。此外，将在监狱的一部分收集所有细菌性皮肤感染患者的培养物18个月，以确定这些感染由MRSA相对于其他细菌引起的频率有多高。一组2128名最高安全级别的成年被拘留者将接受MRSA的殖民测试，以确定被拘留者携带细菌的普遍程度。将在这些被拘留者中进行为期6个月的整群随机研究，以确定是否可以使用含洗必泰的一次性皮肤清洁布来降低MRSA的传播率、定殖率和感染率。所有耐甲氧西林金黄色葡萄球菌分离株和从移居或感染被拘留者的标本中分离的金黄色葡萄球菌样本，以及那些污染监狱表面和物体的标本，将进行基因测试，以确定监狱中存在哪些MRSA菌株。与监狱相关的菌株将与导致社区感染MRSA的菌株进行比较。这项研究可能会确定阻止MRSA在监狱和监狱以及其他地方的健康人中传播的重要方法。我们希望库克县监狱成为控制耐甲氧西林金黄色葡萄球菌和其他耐药细菌的典范监狱。

DESCRIPTION (provided by applicant): The goal of this 3-year project is to control the spread of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in Chicago's Cook County Jail. CA-MRSA is a bacterium which is spreading rapidly through healthy populations, becoming an epidemic in many regions of the country. MRSA causes infections which are difficult and expensive to control because penicillins and similar drugs cannot be used to treat them. Many people in the community are asymptomatically colonized by MRSA. There have been outbreaks of MRSA infections at prisons and jails in the U.S, and they are common at the Cook County Jail. We fear that jails may be sites of rapid MRSA dissemination, in part because CA-MRSA is becoming endemic to the inner city of Chicago. We will study the spread of MRSA in the jail to better understand how the bacteria are transmitted from person to person there and how we can prevent their transmission. All detainees asked to participate must give informed consent to do so; their privacy will be carefully protected. Seventeen objects and surfaces in the jail will first be sampled for contamination with MRSA. We will test the efficacy of 3 disinfectants to decontaminate the 2 most commonly contaminated surfaces or objects that we identify. In addition, cultures will be collected from all patients with bacterial skin infections for 18 months in a part of the jail in order to determine how frequently these infections are caused by MRSA relative to other bacteria. A group of 2128 maximum-security adult detainees will be tested for colonization with MRSA in order to determine how commonly detainees carry the bacterium. A cluster-randomized 6-month study will be undertaken among these detainees to determine if chlorhexidine-containing disposable cloths for skin cleaning can be used to decrease the rate of MRSA transmission, colonization, and infection. All of the MRSA isolates and a sample of the S. aureus isolates susceptible to methicillin from specimens colonizing or infecting detainees, as well as those contaminating surfaces and objects in the jail will be tested genetically in order to determine which strains of MRSA are present in the jail. The jail-related strains will be compared with strains causing MRSA infection in the community. This study may identify important ways to stop the spread of MRSA among healthy people in jails and prisons, as well as other places. We hope that the Cook County jail will become a model jail for the control of MRSA and other resistant bacteria.