221865 Anterior nares colonization with Methicillin-resistant Staphylococcus aureus (MRSA) among chiropractic students: An observational cohort study and epidemiologic survey protocol

Monday, November 8, 2010 : 11:42 AM - 12:00 PM

Jonathon Todd Egan, DC, MPH , New York Chiropractic College, Seneca Falls, NY
Chiropractic students are in frequent skin-on-skin or fomite contact as they train academically. It is likely that chiropractic students become MRSA-colonized at a much higher rate than the US population as a whole, and may therefore be a potential source of MRSA colonization in the community after graduation as they enter chiropractic practice.

The purpose of this observational cohort study and epidemiologic survey is to determine the rate of anterior nares MRSA colonization in chiropractic students, and to compare those rates to cohorts of medical and physical therapy students, as well as to general graduate students. These rates will be compared to published data of anterior nares MRSA colonization rates in the civilian, noninstitutionalized US population. Risk factors for MRSA colonization will be assessed through an epidemiologic survey administered to each swabbed and cultured participant. Multiple regression analysis with stepwise selection will be utilized to determine which risk factors best explain or predict the detected colonization rates among cohorts and overall, and to determine if educational setting is predictive of MRSA colonization. A sufficient number of participants will be sampled and cultured to allow the detection of an increase from the civilian, noninstitutionalized US population background rate of 1.5% to a 4.5% anterior nares colonization rate in each cohort with 80% power on a one-tailed test (with alpha ≤.05). Through this study, the possible contribution of chiropractic education as an predictor of MRSA colonization will be explored. This presentation will review the proposed protocol and background for this study.

Learning Areas:
Occupational health and safety
Protection of the public in relation to communicable diseases including prevention or control
Public health or related research

Learning Objectives:
Articulate the process to assess anterior nares MRSA colonization in chiropractic and other students Describe the usage of nasal swabs and selective growth media to verify colonization Demonstrate the concept of study power to guide sample size and improve the ability to detect the hypothesized colonization rate Explain the use of epidemiologic surveys and procedures to understand factors that contribute to the best model explaining colonization Express the public health threat posed by MRSA and the role chiropractic education and the chiropractic profession may play in the community transmission of MRSA

Keywords: Chiropractic, Infectious Diseases

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I will be conducting the research described in this abstract in partial fulfillment of requirements for my PhD in Public Health/Epidemiology
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
New York Chiropractic College Chiropractic Practice and Education Employment (includes retainer)
Canandaigua VA Medical Center Chiropractic Practice and Education Consultant

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.