ABSTRACT
BACKGROUND: Staphylococcus aureus is the most common cause of Skin and Soft Tissue Infections (SSTIs) in the community in the United States of America. Community Health Centers (CHC) serve as primary care providers for thousands of immigrants in New York. METHODS: As part of a research collaborative, 6 New York City-area CHCs recruited patients with SSTIs. Characterization was performed in all S. aureus isolates from wounds and nasal swabs collected from patients. Statistical analysis examined the differences in wound and nasal cultures among immigrant compared to native-born patients. RESULTS: Wound and nasal specimens were recovered from 129 patients and tested for antibiotic susceptibility. 40 patients were immigrants from 15 different countries. Although not statistically significant, immigrants had lower rates of MRSA infections (n = 15) than did native-born participants, and immigrants showed significantly higher rates of MSSA wound cultures (n = 11) (OR = 3.5, 95% CI: 1.3, 9.7). CONCLUSIONS: In our study, immigrants were more likely to present with SSTIs caused by MSSA than US-born patients. Immigants also reported lower frequencies of antibiotic prescription or consumption in the months prior to SSTI infection. This suggests that antibiotic resistance may vary regionally and that immigrants presenting with SSTIs may benefit from a broader range of antibiotics.
Subject(s)
Anti-Bacterial Agents/pharmacology , Emigrants and Immigrants , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Methicillin/pharmacology , Staphylococcal Infections/epidemiology , Staphylococcal Infections/microbiology , Adolescent , Adult , Aged , Anti-Bacterial Agents/therapeutic use , Community Health Centers , Community-Acquired Infections/epidemiology , Community-Acquired Infections/microbiology , Female , Humans , Male , Methicillin/therapeutic use , Methicillin-Resistant Staphylococcus aureus/drug effects , Microbial Sensitivity Tests , Middle Aged , New York City/epidemiology , Nose/microbiology , Prevalence , Soft Tissue Infections/drug therapy , Soft Tissue Infections/epidemiology , Soft Tissue Infections/microbiology , Staphylococcal Skin Infections/drug therapy , Staphylococcal Skin Infections/epidemiology , Staphylococcal Skin Infections/microbiology , Staphylococcus aureus/drug effects , Staphylococcus aureus/isolation & purification , United States/epidemiology , Wound Infection/microbiology , Wounds and Injuries/microbiology , Young AdultABSTRACT
We applied a robust combinatorial (multi-test) approach to microarray data to identify genes consistently up- or down-regulated in head and neck squamous cell carcinoma (HNSCC). RNA was extracted from 22 paired samples of HNSCC and normal tissue from the same donors and hybridized to the Affymetrix U95A chip. Forty-two differentially expressed probe sets (representing 38 genes and one expressed sequence tag) satisfied all statistical tests of significance and were selected for further validation. Selected probe sets were validated by hierarchical clustering, multiple probe set concordance, and target-subunit agreement. In addition, real-time PCR analysis of 8 representative (randomly selected from 38) genes performed on both microarray-tested and independently obtained samples correlated well with the microarray data. The genes identified and validated by this method were in comparatively good agreement with other rigorous HNSCC microarray studies. From this study, we conclude that combinatorial analysis of microarray data is a promising technique for identifying differentially expressed genes with few false positives.
