@article{StaphylococcusaureusAcquisition:1715,
      recid = {1715},
      author = {Mork, Ryan Lee},
      title = {Staphylococcus aureus Acquisition, Persistence, and  Infection Dynamics in the Household},
      publisher = {The University of Chicago},
      school = {Ph.D.},
      address = {2019-03},
      pages = {176},
      abstract = {Staphylococcus aureus, a Gram-positive prokaryote, is the  most common human pathobiont, capable of asymptomatic  colonization and infection in the majority of the human  population. S. aureus causes infections in both healthy and  hospitalized individuals, with a markedly high rate of  recurrence. Colonization of host by the pathogen serves as  a primary risk factor for initial and recurrent infections.  Host individuals can be colonized with S. aureus across  multiple body sites, commonly shed the organism in their  local environment, and transmit S. aureus to nearby  contacts. Multiple epidemiological and statistical studies  have indicated that efficient prevention of S. aureus skin  and soft tissue infections (SSTIs), as well as invasive  infections, requires a deeper understanding of S. aureus  colonization dynamics in the community and especially in  the household.

     In order to provide the most  comprehensive picture to date of S. aureus colonization  dynamics, we have followed 150 households, comprising 692  individuals over a 12-month period. We recorded the history  of S. aureus infection in these individuals, pairing  information about host demographics and behavior with  temporal colonization status at three body sites, pathogen  environmental sampling, and molecular typing. We  specifically traced the appearance and distribution of the  S. aureus strains causing previous and interval SSTIs in  the household and found these strains commonly present on  household members and their local environment months after  the initial infection. By combining this information with  family pedigrees, we have further found that both  colonization and infection risk are nearly evenly split  between genetic and behavioral factors. 

     Through our  analysis, three major household S. aureus colonization  dynamics types have been delineated and defined: (1)  introductions, the appearance of a novel strain types  across one or more individuals and environmental sites, (2)  transmissions, the acquisition of a new strain type on a  household member previously present within the household,  and (3) persistence events, the continued presence of a  strain type on an individual. These distinct phenomena  share partially overlapping behavioral and hygiene-related  factors, many of which were previously reported as risk  factors for S. aureus colonization. We propose that  colonization risk can be represented as the combination of  individual susceptibility factors to these dynamics.  Successful S. aureus colonization and infection  intervention strategies must accordingly embrace a  comprehensive set of prevention methods that are tailored  to both individual and household attributes.},
      url = {http://knowledge.uchicago.edu/record/1715},
      doi = {https://doi.org/10.6082/uchicago.1715},
}