title: Staphylococcus aureus colonization and infection in New York State prisons.
abstract: Methicillin-resistant Staphylococcus aureus is increasingly responsible for staphylococcal outbreaks in prison. There is limited information on the source of the outbreak strains, risk factors for infection, and transmission of these strains within a prison. We conducted a survey to determine the prevalence of nasal colonization with S. aureus in 2 New York State prisons. S. aureus isolates from clinical cultures collected from all New York State prisons during a 6-month period were compared with the colonizing strains. Analyses were conducted to determine whether prison-level characteristics were associated with colonization or infection with S. aureus. The colonization rate was 25.5% (124/487); 10.5% of the isolates were methicillin resistant, all were staphylococcal chromosomal cassette (SCC)mec type IV, and 61.5% were Panton Valentine leukocidin (PVL) positive. Surprisingly, 21.6% of the methicillin-susceptible isolates were also PVL positive. Of the clinical isolates, 48.3% were methicillin resistant, with 93.1% of the latter being SCCmec type IV and 48.3% being PVL positive. The predominant clone was USA 300. Prison-level risk factors for infection included the proportion of inmates with drug offenses, the length of inmate stay, and the jail from which inmates originated. This study suggests that both new and long-term inmates act as sources of S. aureus strains, with the more virulent of the latter preferentially being selected as pathogens.
authors: Department of Medicine, Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA. fl189@columbia.edu
authors: Franklin D
authors: FD
authors: Lowy
authors: Allison E
authors: AE
authors: Aiello
authors: Meera
authors: M
authors: Bhat
authors: Vicki D
authors: VD
authors: Johnson-Lawrence
authors: Mei-Ho
authors: MH
authors: Lee
authors: Earl
authors: E
authors: Burrell
authors: Lester N
authors: LN
authors: Wright
authors: Glenny
authors: G
authors: Vasquez
authors: Elaine L
authors: EL
authors: Larson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001427:Bacterial Toxins / Q000096:biosynthesis; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D016000:Cluster Analysis; D016521:Electrophoresis, Gel, Pulsed-Field; D005098:Exotoxins / Q000096:biosynthesis; D005260:Female; D005838:Genotype; D006801:Humans; D007956:Leukocidins / Q000096:biosynthesis; D008297:Male; D016106:Methicillin Resistance / Q000235:genetics; D008875:Middle Aged; D017720:Molecular Epidemiology; D009518:New York / Q000453:epidemiology; D009666:Nose / Q000382:microbiology*; D012150:Polymorphism, Restriction Fragment Length; D015995:Prevalence; D011329:Prisoners; D011330:Prisons; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000145:classification / Q000302:isolation & purification*
chemical_list: D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin