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首页> 外文期刊>JMIR Research Protocols >Health Disparities in Staphylococcus aureus Transmission and Carriage in a Border Region of the United States Based on Cultural Differences in Social Relationships: Protocol for a Survey Study
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Health Disparities in Staphylococcus aureus Transmission and Carriage in a Border Region of the United States Based on Cultural Differences in Social Relationships: Protocol for a Survey Study

机译：基于社会关系中的文化差异的美国文化差异：调查研究的卫生障碍在美国金黄色葡萄球菌传播与运输中的卫生差异

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Background Health care–associated Staphylococcus aureus infections are declining but remain common. Conversely, rates of community-associated infections have not decreased because of the inadequacy of public health mechanisms to control transmission in a community setting. Our long-term goal is to use risk-based information from empirical socio-cultural-biological evidence of carriage and transmission to inform intervention strategies that reduce S aureus transmission in the community. Broad differences in social interactions because of cultural affiliation, travel, and residency patterns may impact S aureus carriage and transmission, either as risk or as protective factors. Objective This study aims to (1) characterize S aureus carriage rates and compare circulating pathogen genotypes with those associated with disease isolated from local clinical specimens across resident groups and across Hispanic and non-Hispanic white ethnic groups and (2) evaluate social network relationships and social determinants of health-based risk factors for their impact on carriage and transmission of S aureus . Methods We combine sociocultural survey approaches to population health sampling with S aureus carriage and pathogen genomic analysis to infer transmission patterns. Whole genome sequences of S aureus from community and clinical sampling will be phylogenetically compared to determine if strains that cause disease (clinical samples) are representative of community genotypes. Phylogenetic comparisons of strains collected from participants within social groups can indicate possible transmission within the group. We can therefore combine transmission data with social determinants of health variables (socioeconomic status, health history, etc) and social network variables (both egocentric and relational) to determine the extent to which social relationships are associated with S aureus transmission. Results We conducted a first year pilot test and feasibility test of survey and biological data collection and analytic procedures based on the original funded design for this project (#NIH U54MD012388). That design resulted in survey data collection from 336 groups and 1337 individuals. The protocol, described below, is a revision based on data assessment, new findings for statistical power analyses, and refined data monitoring procedures. Conclusions This study is designed to evaluate ethnic-specific prevalence of S aureus carriage in a US border community. The study will also examine the extent to which kin and nonkin social relationships are concordant with carriage prevalence in social groups. Genetic analysis of S aureus strains will further distinguish putative transmission pathways across social relationship contexts and inform our understanding of the correspondence of S aureus reservoirs across clinical and community settings. Basic community-engaged nonprobabilistic sampling procedures provide a rigorous framework for completion of this 5-year study of the social and cultural parameters of S aureus carriage and transmission.
机译：背景技术医疗保健相关的金黄色葡萄球菌感染是下降但仍然很常见。相反，由于公共卫生机制在社区环境中控制传输的不足，社区相关感染的率并没有减少。我们的长期目标是将基于风险的信息从经验和传播的经验社会文化生物学证据中使用，以告知干预策略，减少社区AURES传播的干预策略。由于文化附属，旅行和居住模式，社会互动的广泛差异可能会影响沙丘运输和传输，无论是风险还是保护因素。目的本研究旨在（1）表征A金黄色葡萄球菌托架率，并将循环病原体基因型与患有与当地临床标本跨越居民群体中分离的疾病的循环病原体基因型进行比较，并跨西班牙裔和非西班牙裔人族群和（2）评估社会网络关系和卫生卫生危险因素的社会决定因素对S金黄色葡萄球菌的运输和传播。方法将社会文化调查与病原体托架和病原体基因组分析结合在人口健康取样方法中，以推断传输模式。与社区和临床采样的全部基因组序列和临床采样的全部基因组序列将在系统发育，以确定导致疾病（临床样本）的菌株是否代表群落基因型。从社会群体中的参与者收集的菌株的系统发育比较可以表明该组内可能的传播。因此，我们可以将传输数据与健康变量（社会经济地位，健康历史等）和社交网络变量（Egocentric和关系）的社会决定因素组合，以确定社交关系与金黄色葡萄球菌传输相关的程度。结果我们对该项目原始资助设计的调查和生物数据收集和分析程序进行了第一年的试验和可行性测试（#NIH U54MD012388）。该设计导致336组和1337人的调查数据收集。下面描述的协议是基于数据评估的修订，统计功率分析的新发现以及精细数据监测程序。结论本研究旨在评估美国边境社区中的沙丘运输的民族普遍性。该研究还将审查亲属和非金属关系在社会群体中的运输患病率协调一致的程度。 S金黄色菌菌株的遗传分析将进一步区分跨社会关系背景推定的传输途径，并告知我们对临床和社区环境的对心肌储层对应的理解。基本社区聘用的非产品采样程序提供了一个严谨的框架，完成了对S金黄色葡萄球菌和传输的社会和文化参数的5年的研究。

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