Project #1: Do Pathogen Genotypes, Carriage, and Social Network Differences Lead to Health Disparities in MRSA/MSSA Infections?

项目总结 与医疗保健相关的(HA)金黄色葡萄球菌感染正在下降，但仍然很常见。相反， 由于控制机制的不足，社区相关感染率并未下降 在社区环境中传播。拉美裔美国人比非拉美裔美国人感染风险更低 白人，而美国印第安人面临着更高的感染风险。造成这种差距的根本原因是 未知。我们的长期目标是使用基于风险的信息，这些信息建立在 传播为减少社区中金黄色葡萄球菌传播的干预策略提供信息。我们的 眼下的目标是确定全国趋势是否反映在尤马的不同种族群体中， 亚利桑那州对感染率和无症状携带者。我们还将确定临床菌株是否 代表社区携带菌株，而不是因为出现了几个高度匹配的谱系。vt.给出 由于不同民族之间的旅行和居住模式在社会互动方面的巨大差异，我们还 目的确定社会关系和互动在金黄色葡萄球菌传播中的作用，无论是 风险或保护性因素。其基本原理是，我们将了解这种健康的潜在原因 差距和对金黄色葡萄球菌传播的重要组成部分的进一步洞察：社区运输， 病原体基因分型，以及社会互动的影响。 具体目标#1.我们将确定金黄色葡萄球菌感染和携带率的特征，并比较循环 从当地临床标本中分离的与疾病相关的病原体基因型别 全职和兼职居民群体，以及西班牙裔和非西班牙裔白人族群。整体 来自社区样本的基因组将与来自临床样本的基因组进行系统发育比较，以 确定临床病原体基因类型的多样性是否具有社区基因类型的代表性。我们预计 找到病原体种群在这些群体中没有差异的证据，这表明病原体 基因类型不能解释金黄色葡萄球菌感染的种族差异。 具体目标2.我们将确定和测试基于社交网络和社交决定因素的风险 影响金黄色葡萄球菌传播的因素。在登记参与者的同时，我们将收集将定义本地 社交“联系”团体。我们将使用健康的社会决定因素和社会网络变量(包括自我- 中心和关系)，以确定社会关系在多大程度上有助于理解S。 通过向参与者询问旨在量化社交中身体接触的问题来实现金色传播 组，2)将他们的鼻部、咽部和手部微生物群描述为接触的独立估计者 和社会接近导致共生物种的传播，3)通过比较进化 金黄色葡萄球菌阳性样本与参与者之间测量或估计的接触水平的相关性。 好了！

PROJECT SUMMARY Healthcare-associated (HA) Staphylococcus aureus infections are declining but remain common. Conversely, rates of community-associated infections have not decreased due to the inadequacy of mechanisms to control transmission in a community setting. Hispanic Americans have a lower risk of infection than non-Hispanic whites, while American Indians face an increased risk for infections. The underlying causes of this disparity are unknown. Our long term objective is to use risk-based information founded upon empirical evidence of transmission to inform intervention strategies that reduce S. aureus transmission in the community. Our immediate goals are to determine whether national trends are reflected within different ethnic groups in Yuma, Arizona vis à vis infection rates and asymptomatic carriage. We will also determine if clinical strains are representative of community-carriage strains and not due to the emergence of a few, highly fit lineages. Given the broad differences in social interactions due to travel and residency patterns among ethnic groups, we also aim to determine the role that social relationships and interactions have on S. aureus transmission, either as risk or protective factors. The rationale is that we will gain an understanding of underlying causes of this health disparity and gain further insights into important components of S. aureus transmission: community carriage, pathogen genotypes, and the impact of social interactions. Specific Aim #1. We will characterize S. aureus infection and carriage rates and compare circulating pathogen genotypes with those associated with disease isolated from local clinical specimens across full- and part-time resident groups, and across Hispanic and Non-Hispanic White ethnic groups. Whole genomes from community sampling will be phylogenetically compared to those from clinical samples to determine if the diversity of clinical pathogen genotypes is representative of community genotypes. We expect to find evidence that pathogen populations do not differ among these groups, suggesting that pathogen genotypes do not explain ethnic based disparities in S. aureus infections. Specific Aim #2. We will determine and test social network- and social determinants-based risk factors for transmission of S. aureus. While enrolling participants, we will collect data that will define local social “contact” groups. We will use social determinants of health and social network variables (both ego- centric and relational) to determine the extent to which social relationships can contribute to understanding S. aureus transmission by 1) asking participants questions designed to quantify physical contact within a social group, 2) characterizing their nasal, pharyngeal, and hand microbiome as independent estimators of contact and social proximity resulting in transmission of commensal species, 3) and by comparing the evolutionary relatedness of S. aureus positive samples with the measured or estimated level of contact among participants. !