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- Title
Staphylococcus aureus Colonization and Infection Among Drug Users: Identification of Hidden Networks.
- Authors
Gwizdala, Robert A.; Miller, Maureen; Bhat, Meera; Vavagiakis, Peter; Henry, Christopher; Neaigus, Alan; Shi, Qiuhu; Lowy, Franklin D.
- Abstract
Objectives. We combined social-network analysis and molecular epidemiology to investigate Staphylococcus aureus among drug users. Methods. From 2003 through 2005, we recruited adult drug users in Brooklyn, New York. Of 501 individuals recruited, 485 participated. Participants were screened for HIV infection and S. aureus carriage, and they answered a questionnaire assessing risk factors for S. aureus. Participants were asked to nominate up to 10 members of their social networks, and they were invited to recruit nominees to participate. Results. We identified 89 sociocentric risk networks, 1 of which contained 327 (67%) members. One third of participants were either colonized (20%) or infected (19%) with S. aureus. Overall strain similarity was unusually high, suggesting spread within and across networks. In multivariate analysis, 7 health-related and drug-use variables remained independently associated with infection. Moreover, 27% of nominees were not drug users. Conclusions. We found a large, linked, hidden network among participants, with no discernible clustering of closely related strains. Our results suggest that once a pathogen is introduced into a sociocentric network of active drug users, an identifiable community S. aureus reservoir is likely created, with significant linkages to the general population.
- Subjects
NEW York (State); STAPHYLOCOCCAL diseases; METROPOLITAN areas; ANALYSIS of variance; INFECTIOUS disease transmission; CONFIDENCE intervals; STATISTICAL correlation; EPIDEMIOLOGY; DIAGNOSIS of HIV infections; HOST-bacteria relationships; MEDICAL screening; MICROBIOLOGY; MULTIVARIATE analysis; NASAL mucosa; RESEARCH funding; SALIVA; SERODIAGNOSIS; SOCIAL networks; STATISTICS; AFFINITY groups; DATA analysis; DRUG abusers; HUMAN research subjects; PATIENT selection; DISEASE risk factors
- Publication
American Journal of Public Health, 2011, Vol 101, Issue 7, p1268
- ISSN
0090-0036
- Publication type
Article
- DOI
10.2105/AJPH.2010.300028