# The Molecular Epidemiology of Staphylococcus aureus Bacteremias During the Opioid Epidemic: A New York Region Perspective

> **NIH NIH R21** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2020 · $169,259

## Abstract

Project Summary/Abstract:
The opioid epidemic has resulted in a striking, nationwide increase in the number of drug-use related deaths and
life-threatening medical complications. It has crossed sociodemographic lines, involving people from all income
levels and age groups. Among the most serious of the medical complications has been the increase in injection
drug use (IDU)-related infections including HIV, hepatitis and invasive bacterial infections. As in the past,
Staphylococcus aureus (SA) accounts for the majority of these infections. Treatment of SA infections in IDU
remains challenging. There have been few recent investigations that have examined the epidemiology and
molecular characteristics of SA in IDU. There is a critical gap in knowledge regarding the resurgence of these
infections. New York City (NYC) is among the areas most affected by the opioid epidemic. A marked increase in
the number of invasive community-based SA infections, especially endocarditis has been noted. This proposal
will prospectively characterize persons with bacteremic IDU-related SA infections and their isolates across NYC.
We hypothesize that the resurgence of SA infections among IDUs: 1) includes distinct IDU populations with
patterns of drug use that differ from those in the past; 2) is associated with, unexplored transmission pathways;
3) has geographic hotspots related to IDU; 4) is associated with the emergence/reemergence of clones adapted
to the drug use environment; and 5) may result in these SA strains spreading into the non-IDU population. Our
aims are: 1) To determine risk factors for community-associated SA bacteremia in IDU compared to non-IDU, in
a prospective cohort across NYC hospitals. A citywide database comparing sociodemographic, clinical and
geospatial data from subjects with and without IDU-related SA bacteremias from healthcare facilities across NYC
will be established. The analysis will identify risks for SA infections among IDUs, create a prediction model to
more readily identify IDUs and develop prevention strategies for this group. 2) To compare the population
structure of IDU and non-IDU SA bacteremic isolates. A maximum likelihood phylogenetic tree will be constructed
and used to help establish relationships among strains and detect potential drug use networks. These will also
be examined by Bayesian methods to reconstruct possible transmission networks. WGS will also identify
virulence genes that contribute to the success of the dominant SA-IDU clones. These studies, performed with
NYC Infectious Diseases physicians and the NYC Department of Health will be important in laying the
groundwork for identifying specific IDU-related risks for infections and developing targeted interventions aimed
at decreasing the number of infection-related complications of IDU.

## Key facts

- **NIH application ID:** 9969857
- **Project number:** 1R21AI152046-01
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Anne-Catrin Uhlemann
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $169,259
- **Award type:** 1
- **Project period:** 2020-03-09 → 2022-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9969857

## Citation

> US National Institutes of Health, RePORTER application 9969857, The Molecular Epidemiology of Staphylococcus aureus Bacteremias During the Opioid Epidemic: A New York Region Perspective (1R21AI152046-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9969857. Licensed CC0.

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