Risk Factors for Spread of Staphylococcus aureus in Prisons.

金黄色葡萄球菌在监狱中传播的危险因素。

• 批准号: 8099625
• 负责人: FRANKLIN D LOWY
• 金额: $ 77.16万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-15 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8099625
• 关键词: Address; Admission activity; Athletic; Attention; Characteristics; Child; Clinical; Collaborations; Communities; Comorbidity; Coupled; Cross-Sectional Studies; Crowding; DNA Fingerprinting; Data; Databases; Development; Disease Outbreaks; Drug usage; Environment; Environmental Exposure; Epidemiology; Geographic Locations; Goals; HIV Infections; Health; Healthcare; Hospitals; Human Resources; Imprisonment; Incidence; Infection; Injection of therapeutic agent; Intake; Intervention; Interview; Jail; Letters; Link; Measures; Medical; Military Personnel; Modality; Molecular; Movement; Native Americans; Nature; Nested Case-Control Study; New York; Pattern; Population; Prevalence; Principal Investigator; Prisoner; Prisons; Public Health; Publications; Recording of previous events; Records; Recruitment Activity; Research; Research Personnel; Risk; Risk Factors; Role; Services; Site; Staphylococcal Infections; Staphylococcus aureus; System; Techniques; Testing; Time; United States; base; community setting; high risk; methicillin resistant Staphylococcus aureus; population based; prevent; programs; therapy design; transmission process

DESCRIPTION (provided by applicant): The dramatic rise in community-based S. aureus infections, many due to methicillin resistant S. aureus (MRSA), has become an important public health problem. This proposal will focus on prisoners, a high-risk group that has received limited attention. Prior studies have examined prison outbreaks without addressing several critical questions. These questions include the role of S. aureus colonization in the prison environment, how S. aureus is introduced into prisons and what the modalities of S. aureus persistence and transmission are in the nonepidemic prison setting. Our long term goal is to develop strategies that will prevent and control transmission of S. aureus within the prison system as well as in similar crowded environments. Our specific aims are the following. 1) We will identify patterns of S. aureus strain transmission within the prison. A cross-sectional analysis of prisoners will be performed to determine the prevalence of S. aureus colonization and/or infection. The role of assigned activities, environmental exposures, prisoner contacts and their spatial proximity in S. aureus transmission will be examined. Bacterial factors associated with the predominance of particular clones of S. aureus will be examined. 2) We will determine the factors associated with the development of clinical infections within the prison. A subset of inmates with culture proven S. aureus infections will be studied in a nested case-control study to determine factors contributing to symptomatic infection in the prison. 3) We will identify risk factors associated with colonization and/or infection with S. aureus at prisoner intake and at release. New prison inmates will be interviewed cultured and their prison/jail records reviewed. Risk factors predictive of S. aureus colonization/infection on arrival will be identified. Because >600,000 prisoners are released into the community each year, they can serve as an important reservoir for staphylococcal transmission. Therefore, S. aureus colonization at the time of release will also be assessed and factors contributing to colonization at release will be examined. This proposal provides an unparalleled opportunity to examine transmission of S. aureus (including MRSA) within the prison setting. The ongoing collaboration of prison personnel with the investigators is unique as is the integration of methodological approaches that will allow us to examine the roles of networks coupled with spatia characteristics in prisons. PUBLIC HEALTH RELEVANCE: This proposal will focus on prisoners, a group at particularly high risk for these infections. The study will investigate how S. aureus is transmitted in this population.

描述（由申请人提供）：以社区为基础的S。金黄色葡萄球菌感染，许多是由于耐甲氧西林的S.金黄色葡萄球菌（MRSA）已成为一个重要的公共卫生问题。这项建议将侧重于囚犯，这是一个受到有限关注的高风险群体。以前的研究审查了监狱爆发，但没有解决几个关键问题。这些问题包括S.金黄色葡萄球菌如何在监狱环境中定植。金黄色葡萄球菌引入监狱和什么样的模式，金黄色葡萄球菌的持久性和传播是在非流行性监狱环境中。我们的长期目标是制定预防和控制S.在监狱系统内以及类似拥挤的环境中，金黄色葡萄球菌的感染率很高。我们的具体目标如下。1)我们将识别S的模式。金黄色葡萄球菌菌株在监狱内的传播。将对囚犯进行横断面分析，以确定S。金黄色葡萄球菌定植和/或感染。研究了指定活动、环境暴露、囚犯接触及其空间邻近性在S.检查金黄色葡萄球菌的传播。细菌因素与优势的特定克隆S。将检查金黄色葡萄球菌。2)我们将确定与监狱内临床感染发展相关的因素。一个囚犯的子集与文化证明S。将在巢式病例对照研究中对金黄色葡萄球菌感染进行研究，以确定导致监狱中出现症状感染的因素。3)我们将确定与S定植和/或感染相关的风险因素。在囚犯接收和释放时的金黄色葡萄球菌。新的囚犯将接受有文化的采访，并审查他们的监狱/监狱记录。预测S.将识别到达时的金黄色葡萄球菌定植/感染。由于每年有超过60万名囚犯被释放到社区，他们可以成为葡萄球菌传播的重要储存库。因此，S.还将评估放行时的金黄色葡萄球菌定殖，并检查放行时促成定殖的因素。这一建议为研究S.金黄色葡萄球菌（包括MRSA）在监狱设置。监狱工作人员与调查人员正在进行的合作是独一无二的，方法上的整合也是独一无二的，这将使我们能够审查网络的作用以及监狱中空间组织的特点。公共卫生相关性：该提案将重点关注囚犯，这是一个感染这些感染的风险特别高的群体。本研究将探讨S.金黄色葡萄球菌在这一人群中传播。