Frequent Methicillin-Resistant Staphylococcus aureus Introductions Into an Inner-city Jail: Indications of Community Transmission Networks
| Autor: | Chad Zawitz, Evan S. Snitkin, Stefan J. Green, Robert A. Weinstein, Michael Schoeny, Darjai Payne, Kyle J. Popovich, Mary K. Hayden, Alla Aroutcheva, Stephanie N. Thiede, Bala Hota |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Methicillin-Resistant Staphylococcus aureus 0301 basic medicine Microbiology (medical) medicine.medical_specialty 030106 microbiology Skin infection medicine.disease_cause Men who have sex with men Sexual and Gender Minorities 03 medical and health sciences 0302 clinical medicine Risk Factors Epidemiology Prevalence Humans Medicine Outpatient clinic Colonization 030212 general & internal medicine Homosexuality Male Articles and Commentaries Chicago Molecular epidemiology business.industry Transmission (medicine) Staphylococcal Infections medicine.disease Methicillin-resistant Staphylococcus aureus Infectious Diseases Female Illinois business Jails Demography |
| Zdroj: | Clin Infect Dis |
| ISSN: | 1537-6591 1058-4838 |
| DOI: | 10.1093/cid/ciz818 |
| Popis: | Background Jails may facilitate spread of methicillin-resistant Staphylococcus aureus (MRSA) in urban areas. We examined MRSA colonization upon entrance to a large urban jail to determine if there are MRSA transmission networks preceding incarceration. Methods Males incarcerated in Cook County Jail (Chicago) were enrolled, with enrichment for people living with human immunodeficiency virus (PLHIV), within 72 hours of intake. Surveillance cultures assessed prevalence of MRSA colonization. Whole-genome sequencing (WGS) identified preincarceration transmission networks. We examined methicillin-resistant Staphylococcus aureus (MRSA) isolates to determine if there are transmission networks that precede incarceration. A large proportion of individuals enter jail colonized with MRSA. Molecular epidemiology and colonization risk factors provide clues to community reservoirs for MRSA. Results There were 718 individuals (800 incarcerations) enrolled; 58% were PLHIV. The prevalence of MRSA colonization at intake was 19%. In multivariate analysis, methamphetamine use, unstable housing, current/recent skin infection, and recent injection drug use were predictors of MRSA. Among PLHIV, recent injection drug use, current skin infection, and HIV care at outpatient clinic A that emphasizes comprehensive care to the lesbian, gay, bisexual, transgender community were predictors of MRSA. Fourteen (45%) of 31 detainees with care at clinic A had colonization. WGS revealed that this prevalence was not due to clonal spread in clinic but rather to an intermingling of distinct community transmission networks. In contrast, genomic analysis supported spread of USA500 strains within a network. Members of this USA500 network were more likely to be PLHIV (P < .01), men who have sex with men (P < .001), and methamphetamine users (P < .001). Conclusions A large proportion of individuals enter jail colonized with MRSA. Molecular epidemiology and colonization risk factors provide clues to identify colonized detainees entering jail and potential community reservoirs of MRSA. |
| Databáze: | OpenAIRE |
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