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A combination of molecular epidemiologic techniques with social network methodology to identify patterns of Staphylococcus aureus transmission among drug users in Bedford-Stuyvesant, Brooklyn

Rosa J Ergas, MPH1, Peter Vavagiakis, MS2, Christopher Henry1, Christian Cespedes1, and Franklin D. Lowy, MD1. (1) Department of Medicine, Division of Infectious Diseases, Columbia University, 630 W. 168th St., P&S 9-468, New York City, NY 10032, 718-230-4075, rje57@hotmail.com, (2) Panna Technologies, 348 West 21st, Suite 2R, New York City, NY 10011

Objectives: Identification of patterns of S. aureus colonization and spread among active drug users and their contact networks over time.

Methods: Snowball sampling is used to recruit subjects from a population of current drug users in a low-income, predominantly African-American/black neighborhood in New York City. A coupon system facilitates and tracks secondary recruitment of named network members and additional contacts that share social and/or drug use settings. Social network methodology describes an array of potential risk relationships for S. aureus transmission. Participant linkages are defined by a combination of geographic, temporal, sexual, and drug use partnerships. Nasal and paraphernalia cultures as well as cultures of sites of infection for S. aureus are used to assess the prevalence of colonization and to characterize molecularly distinct isolates of S. aureus. Related S. aureus isolates are defined by molecular fingerprinting and these isolates are then compared to social and risk networks.

Results: Ninety-three primary participants with 212 secondary recruits have been enrolled using the coupon system. Of these 305 participants, 69% have used crack, 44% have used cocaine, 66% have used heroin and 25% have injected in the 6 months prior to interview.  14% are HIV positive.  Of the 250 nasal swabs tested to date for the presence of S. aureus 39 (15.6%) are positive.

Conclusions: These techniques represent a method for study of transmission of S. aureus within high risk groups.  This approach can be applied to recruit hard to reach populations and to describe and characterize transmission of infectious diseases within networks and in communities.

 

Learning Objectives:

Keywords: Network Analysis, Drug Use

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Infectious Disease Epidemiology: Poster Session

The 132nd Annual Meeting (November 6-10, 2004) of APHA