Popovich Kyle J, Thiede Stephanie N, Zawitz Chad, Payne Darjai, Aroutcheva Alla, Schoeny Michael, Green Stefan J, Snitkin Evan S, Weinstein Robert A, Payne Darjai
Rush University Medical Center/Cook County Health, Chicago, Illinois, USA.
University of Michigan, Ann Arbor, Michigan, USA.
Open Forum Infect Dis. 2022 Jan 31;9(3):ofac049. doi: 10.1093/ofid/ofac049. eCollection 2022 Mar.
It is unclear if there are differences in methicillin-resistant (MRSA) risk between sexes in high-risk populations.
Females incarcerated at the Cook County Jail were enrolled within 72 hours of intake. Surveillance cultures (nares, throat, groin) were collected to determine the prevalence of MRSA colonization. A survey was administered to identify colonization predictors. Univariate and multivariate analyses were performed to identify predictors of colonization at intake. Genomic sequencing was performed on MRSA colonization and archived clinical isolates.
Two hundred fifty women were enrolled (70% African American, 15% Hispanic), with 70% previously in jail. The prevalence of MRSA colonization at intake was 20%, with 42% of those colonized solely in the throat or groin. Univariate predictors of MRSA colonization at entrance were illicit drug use, unstable housing, engaging in anal sex, recent exchange of sex for drugs/money, and a higher number of recent sexual partners. With multivariate adjustment for race/ethnicity, use of needles for illicit drugs was a significant predictor of MRSA. Use of illicit drugs was also associated with inclusion in a genomic cluster. Nares colonization was significantly associated with being in a genomic cluster (18.8% vs 78.6%; < .001), whereas exclusive extranasal colonization was associated (odds ratio, 15.89; < .001).
We found that a high proportion (20%) of females entered jail colonized with MRSA, suggesting that previously reported sex disparities of a lower risk in women may not apply to high-risk populations. Our findings suggest high-risk activities or venues in the community for MRSA, with potential for directing sex-specific interventions.
在高危人群中，耐甲氧西林金黄色葡萄球菌（MRSA）感染风险在性别上是否存在差异尚不清楚。
库克县监狱收押的女性在入狱72小时内被纳入研究。采集监测培养样本（鼻腔、咽喉、腹股沟）以确定MRSA定植的患病率。进行一项调查以确定定植预测因素。进行单因素和多因素分析以确定入狱时定植的预测因素。对MRSA定植和存档的临床分离株进行基因组测序。
共纳入250名女性（70%为非裔美国人，15%为西班牙裔），其中70%曾入狱。入狱时MRSA定植的患病率为20%，其中42%仅在咽喉或腹股沟定植。入狱时MRSA定植的单因素预测因素为使用非法药物、住房不稳定、肛交、近期以性换毒品/金钱以及近期性伴侣数量较多。在对种族/族裔进行多因素调整后，使用非法药物注射针头是MRSA的一个显著预测因素。使用非法药物还与基因组聚类有关。鼻腔定植与基因组聚类显著相关（18.8%对78.6%；P<0.001），而仅鼻外定植也与之相关（比值比，15.89；P<0.001）。
我们发现，很大一部分（20%）女性入狱时已感染MRSA，这表明先前报道的女性风险较低的性别差异可能不适用于高危人群。我们的研究结果表明社区中存在MRSA的高危活动或场所，有针对性别特异性干预措施的潜力。
