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

项目总结 金黄色葡萄球菌是一种细菌，可引起皮肤、肺部、血液和 内脏。这些感染可以在社区或医疗保健中发病。 环境，包括由耐甲氧西林S。 金黄色葡萄球菌(MRSA)。大约28%-50%的人是该物种的无症状携带者 身体。金黄色葡萄球菌菌株在社区和医院的相互作用尚未得到 经过充分的研究。虽然我们认为金黄色葡萄球菌可以在人与人之间传播 医院，我们不确定这种情况发生的频率，如果一些菌株比 医院里的其他人，以及患者感染金黄色葡萄球菌的频率 带上他们自己的身体。此外，目前还不清楚生物(无生命)有多重要 物体)或医护人员的身体是传播S。 在医院里，病人之间的金黄色葡萄球菌。这项研究将基于来自全球的数据 大学医院两个单位采集的金黄色葡萄球菌基因组测序 宾夕法尼亚州(HUP)。在24个月内，我们将在所有患者入院时对其进行金黄色葡萄球菌检测。 4个身体部位的定植。对于被金黄色葡萄球菌定居的一部分受试者，我们将测试 在他们的病房里为金黄色葡萄球菌聚集。我们会选择那些没有 入院时携带金黄色葡萄球菌并检测他们的房型以确定有什么风险 影响金黄色葡萄球菌在医院内传播的因素有很多。使用WGS，我们将测试所有 在研究单位上引起感染的细菌，看看特定菌株传播的频率，以及 我们将确定金黄色葡萄球菌的一些遗传特征是否会使它们更有可能传播 和/或更有可能引起感染。此外，每个月，我们都会测试 研究单位医务工作者的鼻子和手套，看看他们是否携带金黄色葡萄球菌。我们将测试常见的 这些单位的区域，看看合胞菌是否携带金黄色葡萄球菌。我们将确定是否有任何传播 金黄色葡萄球菌菌株可在HCW或公共区域融合群中发现。我们将检查所有感染S。 在重叠的2年时间里，Aureus从整个850个床位的HUP中分离出基因组 确定金黄色葡萄球菌远距离传播导致感染的证据。我们希望能更好地 了解金黄色葡萄球菌毒力和传播性的遗传标记。我们将测试 假设传播的金黄色葡萄球菌菌株发展出一组不同的质粒组，这 金黄色葡萄球菌是编码抗生素耐药性或毒力因子的可移动遗传元件 可能携带也可能不携带。根据这些结果，我们可能能够识别出携带高风险的患者。 金黄色葡萄球菌的分离，并制定策略，以防止这种细菌在未来的传播。

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.