Community-Associated Staphylococcus aureus ... - SWACM

CA-MRSA Transmission Dynamics• Molecular typing will be performed on all recoveredCA-MRSA isolates– Determine whether infecting strains resemble:• Endogenous colonizing strains• Strains recovered from household contacts• Strains recovered from environmental surfaces– Identify the directionality of transmissionSummary• CA-MRSA is a significant health burden• Colonization is often associated with subsequentinfections• A household decolonization approach reducesthe incidence of SSTI compared to an individualapproach• Decolonization should be applied to specificgroups• Widespread use of decolonization measures maylead to resistance• Fritz Research Team– Patrick Hogan, MPH– Duha Al-Zubeidi, MD– Madeline Martin, RN, BSN– Mary Boyle, RN, MSN– Carol Patrick– Lauren Singh, MPH– Meghan Butler, BS– Ali Ainsworth, BS– Marcela Rodriguez, MDAcknowledgements• Mentorship– Victoria Fraser, MD– Gregory Storch, MD– Alan Schwartz PhD, MD– Jane Garbutt, MB ChB• Collaborators– Carey-Ann Burnham, PhD– David Hunstad, MD– George Weinstock, PhD– Bernard Camins, MD– Robert Kennedy, MD– Sarah Gehlert, PhD– Rachel Orscheln, MD– SLCH Microbiology Laboratory– SLCH PAWS– WU PAARC Clinicians and StaffBaseline Mupirocin Resistance by Participant FactorsParticipant FactorsMupirocin ResistantN=23 (%)Mupirocin SusceptibleN=1066 (%)Female 10/23 (43) 623/1066 (58) 0.20pAfrican-American Race 17/23 (74) 679/1060 (64) 0.60BacterialGeneticFactorsTHEPERFECTSTORMHumanGeneticFactorsInsurance: Government Issued orSelf-Pay15/17 (88) 542/774 (70) 0.18Co-morbid Health Condition 6/9 (67) 254/474 (54) 0.52Skin Disorder 7/15 (47) 273/803 (34) 0.41Antibiotic Use in Past Year 14/15 (93) 452/791 (57) 0.006Emergency Department or UrgentCare Visit in Past Year7/9 (78) 191/474 (40) 0.04Hospitalization in Past Year 6/15 (40) 127/800 (16) 0.02Surgery in the Past Year 1/9 (11) 91/474 (19) 1.00SSTI in Prior Year 9/15 (60) 346/798 (43) 0.29Household Contact SSTI inPrior Year12/15 (80) 336/798 (42) 0.006Healthcare Worker in Household 6/15 (40) 210/802 (26) 0.24Pet in Household 2/15 (13) 349/803 (44) 0.0313