Elucidating the role of jails in MRSA community transmission

University Of Michigan At Ann Arbor, Ann Arbor MI

Investigators

Abstract

ABSTRACT Methicillin-resistant Staphylococcus aureus (MRSA) is a serious public health threat due to its high prevalence in community and healthcare settings and the increased morbidity and mortality among individuals infected with this pathogen. In 2017, there were over 300,000 reported MRSA cases and roughly 11,000 deaths in the U.S. 1 Although overall rates of MRSA infection have recently decreased nationwide, this has not occurred in people from racial and ethnic minority populations, where rates of healthcare-associated (HA), healthcare-associated community-onset (HACO), and community-acquired (CA) MRSA are much higher, particularly among Black people, as compared to white individuals. In addition, we understand that jails have a disproportionately high prevalence rate of MRSA (19%) and a disproportionate representation of Black and Hispanic populations. Detainees have high reincarceration rates, with about 76.6% of prisoners being rearrested within five years. Once released, detainees interact with the community they came from before entering the jail, potentially leading to transmission events. What is not well-understood is whether jails amplify community MRSA transmission or simply reflect elevated community rates in areas subject to high incarceration rates. We propose to investigate the relationship between jail-based transmission of MRSA and community-level infection risks using detailed genomic data in conjunction with hierarchical regression and individual-based modeling. The results of these studies will help elucidate whether jails amplify community transmission, especially among racial and ethnic minority populations, and may perpetuate high rates of MRSA infection and/or colonization among incarcerated individuals and their communities. Understanding this phenomenon will allow us to improve MRSA surveillance in these communities and design and increase targeted interventions in populations with health disparities and within jails that potentially feed into their communities.