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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
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Frequent Methicillin-Resistant Staphylococcus aureus Introductions Into an Inner-city Jail: Indications of Community

Kyle J Popovich1, Evan S Snitkin2, Chad Zawitz3

  • 1Division of Infectious Diseases, Rush University Medical Center/Cook County Health, Chicago, Illinois, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|August 20, 2019
PubMed
Abstract

Insights

Many individuals enter jail already colonized with methicillin-resistant Staphylococcus aureus (MRSA). Whole-genome sequencing reveals diverse community transmission networks, not clonal spread, are responsible for MRSA colonization prior to incarceration.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Epidemiology

Background:

  • Jails can act as hubs for the transmission of methicillin-resistant Staphylococcus aureus (MRSA) in urban environments.
  • Understanding MRSA colonization at jail intake is crucial for identifying pre-incarceration transmission networks.

Purpose of the Study:

  • To investigate the prevalence of MRSA colonization upon entry into a large urban jail.
  • To determine if MRSA transmission networks exist in the community prior to incarceration.

Main Methods:

  • Enrolled male inmates within 72 hours of intake at Cook County Jail, with a focus on people living with human immunodeficiency virus (PLHIV).
  • Collected surveillance cultures to assess MRSA colonization prevalence.
  • Utilized whole-genome sequencing (WGS) to identify pre-incarceration transmission networks.

Main Results:

  • 19% of 718 individuals were colonized with MRSA at intake. Methamphetamine use, unstable housing, skin infections, and injection drug use were key predictors.
  • Among PLHIV, recent injection drug use, skin infections, and care at a specific comprehensive clinic were predictors.
  • WGS indicated distinct community transmission networks, not clonal spread, for most MRSA strains, though USA500 strains showed network spread.

Conclusions:

  • A significant proportion of individuals entering jail are already colonized with MRSA.
  • Molecular epidemiology and colonization risk factors help identify colonized detainees and potential community MRSA reservoirs.
Keywords:
MRSAcommunity-associated MRSAepidemiologyincarcerationwhole genomic sequencing

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