Analysis of CA-MRSA Transmission: An ED Population Sampling Strategy

Study Overview
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Brief Summary
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Given that the Emergency Department (ED) has become the entry way for large populations of patients into the health care system, a strategy of sampling MRSA isolates in ED populations and merging this information with patient-level data may present a window to hypothesize and investigate CA-MRSA transmission within the community and its impact on hospital-acquired infections.

Detailed Description
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Prospective cross-sectional study involving 500 patients enrolled over a one year period at the UFHealth Shands Hospital's Adult and Pediatric Emergency Department. The collected information will serve as pilot data for a future large comprehensive multi-site study. Patients will have a wound culture and a nasal swab obtained as part of the study, which will be assessed for MRSA isolates using next-generation whole genome sequencing. The principal investigator or PI designee will also survey participants and review hospital records.

Official Title
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Molecular Epidemiology and Phylodynamic and Phylogeographic Analysis of Community-associated Methicillin-resistant Staphylococcus Aureus (CA-MRSA) Transmission: An Emergency Department Population Sampling Strategy

Conditions
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Methicillin-Resistant Staphylococcus Aureus

Intervention / Treatment
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* Other: Acute Abscess Group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient or Legally Authorized Representative (LAR) must have voluntarily signed an Institutional Review Board-approved informed consent form before initiation of any study procedures Patient presents with an acute abscess or a non-post-operative skin/soft tissue infection Patient presents through the UFHealth Shands Emergency Department Exclusion Criteria: Patients who are employed by UFHealth and provide direct patient care Patients who have previously been enrolled in the study Patients who are not suitable for the study in the opinion of the investigator

Ages Eligible for Study
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Minimum Age: 1 Month

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Acute Abscess Group<br>Adults and pediatric patients presenting to the UFHealth Shands Emergency Department with evidence of an acute abscess, or skin/soft tissue infection, which can be sampled for culture and sensitivity testing will be recruited. | Other: Acute Abscess Group<br>* Samples collected for culture and sensitivity testing depending on acute abscess, or skin/soft tissue infection.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Strain Relatedness Identification Through Phylogenetic Analysis | Molecular (spa-typing) and genomic (WGS) relatedness of MRSA strains in isolates in ED populations presenting with SSTIs. | 1 Hour | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Strain Transmission Through Analysis of Genetic Clustering | Phlyodynamic analysis of MRSA transmission course by strain | 1 year | 
| Patient Level Characteristics of Skin and Soft Tissue Infection (SSTI) Presentation | To determine patient-level characteristics, including social and medical history, associated with a presentation related to SSTIs. | 6 Months | 
| Pediatric and Adult Population Presentation Characteristics in Skin and Soft Tissue Infection (SSTI) | Compare patient-level characteristics and phylogenetic clustering between pediatric and adult patients presenting with SSTIs. | 6 Months |