Elucidating the role of jails in MRSA community transmission

项目摘要 根据疾病中心的说法，耐甲氧西林的金黄色葡萄球菌是一个严重的威胁 控制和预防(CDC)，因为感染者的发病率和死亡率增加 1作为一种常见的医疗保健和社区相关病原体，mrsa负担很大。 2017.1年有超过300,000个病例和大约11,000人死亡，尽管耐甲氧西林金黄色葡萄球菌的总体比率 全国范围内的感染率一直在下降，这并没有在有色人种社区表现出来，因为 医疗保健相关(HA)、医疗保健相关社区发病(HACO)和社区获得性(CA) 与白人相比，黑人的耐甲氧西林金黄色葡萄球菌要高得多。2-6此外，我们了解到监狱有 耐甲氧西林金黄色葡萄球菌的患病率高得不成比例(19%)，有色人种比例高。 累犯率高，约76.6%的囚犯在五年内再次被捕。8一旦获释， 被拘留者在进入监狱之前与他们来自的社区互动，导致潜在的传播 事件。目前还不太清楚的是，监狱本身是否是MRSA社区传播的放大器。 在这项建议中，我们将调查MRSA的监狱传播与潜在的 通过利用基于基因组的回归方法和 基于个体的建模。这一结果将阐明监狱如何放大社区传播，特别是 在有色人种社区中，并可能使耐甲氧西林金黄色葡萄球菌的高感染率和/或殖民率永久化。 了解这一现象将使我们能够改进这些社区的MRSA监测并设计 并在有色人种社区和监狱内增加有针对性的干预措施，这些干预措施可能会影响他们的 社区。

Project Summary Methicillin-resistant Staphylococcus aureus is a serious threat according to the Centers for Disease Control and Prevention (CDC), due to the increased morbidity and mortality among individuals who are infected with this pathogen.1 As a common healthcare- and community-associated pathogen, MRSA has a high burden of disease with over 300,000 cases and roughly 11,000 deaths in 2017.1 Though the overall rates of MRSA infection have been decreasing nationwide, this has not translated in communities of color, as the rates of healthcare-associated (HA), healthcare-associated community onset (HACO), and community-acquired (CA) MRSA is much higher among blacks compared to white individuals. 2–6In addition, we understand that jails have a disproportionately high prevalence rate of MRSA (19%) and a high proportion of people of color.7,8 Detainees have high rates of recidivism with about 76.6% of prisoners are rearrested within five years. 8 Once released, detainees interact with the community they came from prior entering the jail, resulting in potential transmission events. What is not well-understood is if jails themselves are an amplifier of MRSA community transmission. In this proposal, we will investigate the relationship between jail transmission of MRSA and the potential of transmission spillover into the wider community by utilizing genomic-based regression approaches and individual-based modelling. The results will elucidate how can jails amplify community transmission, especially among communities of color, and may perpetuate high rates of MRSA infections and/or colonization. Understanding this phenomenon will allow us to improve MRSA surveillance in these communities and design and increase targeted interventions in communities of color and within jails that potentially feed into their communities.