Extra-nasal Colonization and Epidemiology of Community-Associated MRSA

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DESCRIPTION (provided by applicant): Dr. Kyle Popovich, Clinical Instructor in the Department of Medicine at Rush University (RUMC), seeks support for research and career development to establish a career as an independent clinical investigator in the field of hospital epidemiology. Her research interest is community-associated methicillin-resistant S.aureus (CA-MRSA); she has been the first author on 4 peer-reviewed manuscripts, has published 2 review articles and co-authored and been the sole author of 2 editorials on CA-MRSA, and has presented 6 abstracts of her work in oral scientific sessions at national meetings. Dr. Popovich will work under the mentorship of Dr. Robert Weinstein, an international leader in healthcare epidemiology; Mary Hayden, MD (co-mentor), Director, Division of Clinical Microbiology, RUMC and an accomplished researcher in hospital epidemiology; and Dr. Bala Hota (co-mentor), an investigator with expertise in biostatistics and computer algorithms for infection surveillance. In addition to this core interdisciplinary mentorship team, 4 advisory members will critically evaluate research and career development-Dr. Scott Fridkin of the CDC; Dr. Sharon Welbel, Hospital Epidemiologist in the Cook County Health and Hospitals System; Dr. Carol Kauffman, Professor of Medicine (Infectious Diseases), University of Michigan; and Dr. Gordon Trenholme, Director, Section of Infectious Diseases, RUMC. Dr. Popovich is acquiring new skills in research methodology and biostatistics by currently taking classes toward a Masters of Science in Epidemiology at the University of Illinois at Chicago, School of Public Health. She is working in a well-funded, nurturing environment that has produced major epidemiologic and intervention studies of healthcare-associated infections. The strong existing infrastructure for collaborative research between Cook County Hospital and RUMC and the interdisciplinary approach of Dr. Popovich's proposal will allow her to develop the essential skills and experience needed to become an independent researcher capable of applying for an R-01 at the end of the award period. In prior studies, Dr. Popovich demonstrated that CA-MRSA strains are replacing traditional hospital MRSA strains as causes of nosocomial infection. The CA-MRSA epidemic is currently disproportionately affecting particular patient populations (e.g., younger adults). This proposal is an extension of this and has 2 aims: (1) determine the extent to which CA-MRSA strains colonize extra-nasal sites and (2) determine the extent to which exclusive extra-nasal CA-MRSA colonization occurs among patients age = 30. Hypotheses are: (1) prevalence of extra-nasal colonization with CA-MRSA strains is higher than that of non-CA-MRSA strains and (2) a cohort of patients age = 30 will have a 3.5 fold greater prevalence of extra-nasal CA-MRSA colonization in comparison to a patients age>30. To test these hypotheses, colonization surveillance and an established electronic data warehouse will be used. Findings will inform a future project (R-01) examining the origin of CA-MRSA strains causing nosocomial infections and testing infection prevention strategies for reducing spread of the CA-MRSA epidemic. Relevance: While originally affecting individuals without prior healthcare exposures, the community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) epidemic has emerged as a cause of invasive infection in the hospital, with particular populations being disproportionately affected. The goal of this project is to further characterize the epidemiology and colonizaiton dynamics of CA-MRSA strains in order develop and test prevention strategies in hospital settings.