Staphylococcus aureus SPREAD (S. aureus Study of Prevalence Resistance and Environmental Dissemination)

项目摘要 金黄色葡萄球菌是一种引起皮肤、肺、血液和皮肤感染的细菌。 内脏这些感染可以在社区或卫生保健中发病 环境，包括由称为耐甲氧西林S. 金黄色葡萄球菌（MRSA）。大约28-50%的人是这种病毒的无症状携带者， 尸体S.社区和医院的金黄色葡萄球菌菌株还没有被 充分研究。而我们认为S.金黄色葡萄球菌可以在人与人之间传播， 在医院，我们不确定这种情况发生的频率，如果一些菌株比 其他人在医院，以及感染的频率如何导致从S。金黄色葡萄球菌， 带在自己身上。此外，目前还不清楚污染物（无生命） 对象）或医护人员（HCW）的身体作为传播S的中间载体。 在医院里从一个病人传染给另一个病人。这项研究将基于来自整个 基因组测序（WGS）。在大学医院的两个单位收集的金黄色葡萄球菌 宾夕法尼亚州（HUP）在24个月内，我们将在所有患者入院时检测S。金黄色 4个身体部位的定植。对于一个被S. aureus我们将测试 在他们的病房为S.金黄色。我们会选择那些没有 与S.金黄色葡萄球菌在入院和测试他们的房间fomites，以确定什么风险 影响因素是S.金黄色葡萄球菌在医院使用WGS，我们将测试所有 在研究单位引起感染的细菌，看看特定菌株传播的频率， 我们将确定S.金黄色葡萄球菌使它们更容易传播 和/或更可能引起感染。此外，每个月，我们将测试一个样本， 鼻子和手套的HCW的研究单位，看看他们是否携带S。金黄色。我们将共同测试 这些单位的面积，看看是否fomites携带S。金黄色。我们将确定是否有任何传播 S.在HCW或公共区域污染物上发现金黄色葡萄球菌菌株。我们将检查所有感染S。 金黄色葡萄球菌分离基因组从整个850床HUP在重叠的2年期间， 确定了S.引起感染的金黄色葡萄球菌。我们希望能更好 了解S.金黄色。我们将测试 假设S.传播的金黄色葡萄球菌形成了一个独特的质粒集合， 是编码抗生素抗性或毒力因子的移动的遗传元件，S.金黄色 可能携带或不携带。有了这些结果，我们也许能够识别携带高风险的患者。 S.金黄色葡萄球菌的分离和发展战略，以防止这种细菌的传播在未来。

PROJECT SUMMARY Staphylococcus aureus is a bacterial species that causes infections of the skin, lungs, blood and internal organs. These infections can have their onset in the community or in the health care setting, including those caused by antimicrobial-resistant strains called methicillin-resistant S. aureus (MRSA). About 28-50% of all people are asymptomatic carriers of this species on their bodies. The interaction of S. aureus strains in the community and in hospitals has not been adequately studied. While we think that S. aureus can spread from person to person in hospitals, we are not sure how often that happens, if some strains spread more readily than others in the hospital, and how often infections result from the S. aureus bacteria that patients bring with them on their own bodies. Also, it is unclear how important fomites (inanimate objects) or the bodies of healthcare workers (HCWs) are as intermediate carriers in spreading S. aureus from patient to patient in the hospital. This study will be based on data from whole genome sequencing (WGS) of S. aureus collected in two units at the Hospital of the University of Pennsylvania (HUP). For 24 months, we will test all patients upon admission for S. aureus colonization of 4 body sites. For a subset of subjects colonized with S. aureus, we will test fomites in their hospital room for S. aureus. We will choose control patients who are not colonized with S. aureus on admission and test their room fomites to determine what the risk factors are for acquisition and spread of S. aureus in the hospital. Using WGS we will test all of the bacteria causing infections on the study units to see how often specific strains spread, and we will determine whether some genetic traits of S. aureus make them more likely to spread and/or more likely to cause infections. In addition, each month, we will test a sample of the noses and gloves of HCWs on study units to see if they carry S. aureus. We will test common areas of these units to see if fomites carry S. aureus. We will determine if any of the spreading S. aureus strains are found on HCWs or common-area fomites. We will examine all infecting S. aureus isolate genomes from the entire 850-bed HUP during an overlapping 2-year period to identify evidence for distant spread of S. aureus causing an infection. We hope to better understand the genetic markers of virulence and transmissibility in S. aureus. We will test the hypothesis that strains of S. aureus that spread develop a distinct collection of plasmids, which are mobile genetic elements coding for antibiotic resistance or virulence factors that S. aureus may or may not carry. With these results, we may be able to identify patients carrying high-risk S. aureus isolates and develop strategies to prevent the spread of this bacterium in the future.