This retrospective study assesses invasive breast cancer counts reported at the Illinois ZIP code scale during the study period of 1996 to 2000. The research objective is to evaluate the spatial and statistical associations between breast cancer risk and sources of potential environmental contamination. A thorough literature review illustrates a profound list of cancer risk factors within the study space. Public health principles are utilized to prepare breast cancer incidence for analysis, accompanied with the development of a case/control ecological model. Exploratory analyses suggest that breast cancer intensity is predominantly a rural problem. A generalized linear mixed model is employed, illustrating statistical associations between environmental risk factors and breast cancer risk. Coal Mines, Oil/Gas Wells, and Large Quantity Hazardous Waste Generators, display high statistical significance (p<0.001) in association with increased breast cancer risk. Unique socioeconomic attributes distinguish urban risk from rural risk, as can be seen in a discriminant function analysis. The modeling techniques utilized in this research display classic spatial epidemiological approaches that account for particular types of confounding effects, while also defining zones of disease risk through cluster detection. Results from this analysis are useful for future studies intended to account for epidemiological, clinical, chemical and biological disease-related information.

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Agradecemos a compreensão. on 2016-07-04T12:49:01Z (GMT) / Submitted by LETICIA CHAMMA LASTÓRIA (lelastoria@yahoo.com.br) on 2016-07-06T13:41:54Z No. of bitstreams: 1 Mestrado com ficha catalográfica pdf.pdf: 2116809 bytes, checksum: 85e18d24252e4dc8707e401c57bbe62c (MD5) / Approved for entry into archive by Ana Paula Grisoto (grisotoana@reitoria.unesp.br) on 2016-07-06T16:29:34Z (GMT) No. of bitstreams: 1 lastoria_lc_me_bot.pdf: 2116809 bytes, checksum: 85e18d24252e4dc8707e401c57bbe62c (MD5) / Made available in DSpace on 2016-07-06T16:29:34Z (GMT). No. of bitstreams: 1 lastoria_lc_me_bot.pdf: 2116809 bytes, checksum: 85e18d24252e4dc8707e401c57bbe62c (MD5) Previous issue date: 2016-02-25 / Staphylococcus aureus resistente à meticilina (Methicillin-resistant S. aureus, MRSA) é cada vez mais reconhecido como uma ameaça para pessoas vivendo com HIV/AIDS (PVHA). No entanto, a magnitude da colonização por MRSA varia entre diferentes países e regiões geográficas. Nós realizamos um estudo que teve por objetivo identificar a prevalência e os fatores de risco para colonização por S. aureus como um todo e MRSA em PVHA residindo em cidades de pequeno porte do interior do Estado de São Paulo. Isolados de MRSA foram caracterizados por Eletroforese em Gel de Campo Pulsado (Pulsed-Field Gel Electrophoresis, PFGE) e tiveram o Cassete Cromossômico Estafilocóccico (Staphylococcal Chromosome Cassete, SCC) mec tipado. Análise espacial foi realizada para identificar agregados geográficos e correlação com indicadores socioeconômicos. No primeiro momento, realizamos um estudo de prevalência pontual coletando swab nasal e de orofaringe de 368 PVHA atendidas em ambulatório de referência em Botucatu, SP. Sessenta e sete sujeitos residentes na cidade sede foram seguidos com coletas em dois outros momentos, e tiveram seus contactantes domiciliares também investigados para colonização. As taxas de prevalência de S. aureus e MRSA no primeiro levantamento foram 25,8% e 2,7%. A colonização por S. aureus foi negativamente associada com o uso de antibióticos beta-lactâmicos e drogas ilícitas. Por outro lado, fatores de risco para MRSA incluíam uso de crack e internação hospitalar recente. Inquéritos repetidos identificaram novos casos de colonização por MRSA, mas nenhum sujeito apresentou positividade em mais de uma ocasião. Quatro clusters foram identificados na PFGE, agrupando sujeitos em diferentes níveis – domicílio, cidade, região. Dos 19 isolados caracterizados, apenas um não carreava o SCCmec tipo IV. Análise espacial identificou hot spots par sujeitos colonizados com S. aureus, mas não conseguimos ligar esse padrão a indicadores sócio-econômicos. Em conclusão, nós idenficamos baixa – mas relevante – prevalência de MRSA em PVHA. Foram identificados tanto fatores de risco tradicionalmente associados a aquisição na comunidade quanto outros ligados a exposição a hospitais, de modo que as rotas predominantes de transmissão não puderam ser determinadas com base epidemiológica. / Methicillin-resistant Staphylococcus aureus (MRSA) is increasingly recognized as a threat for people living with HIV/AIDS (PLWHA). However, the magnitude of asymptomatic MRSA colonization in that group varies among different countries and geographic regions. We conducted a study that aimed at identifying the prevalence and risk factors for both overall S. aureus and MRSA colonization among PLWHA attending in small cities from inner São Paulo State, Brazil. MRSA isolates were characterized using Pulsed-Field Gel Electrophoresis (PFGE), and submitted to typing of the Staphylococcal Chromosome Cassete (SCC)mec. Spatial analysis was performed to search for geographical clusters and correlation with socioeconomic indicators. In a first point prevalence survey, nasal and oropharyngeal swabs of 368 people were collected. Sixty-seven subjects from the main city (Botucatu) were surveyed for colonization in two other occasions, and had swabs collected from household members. The prevalence rates for S. aureus and MRSA in the first survey were 25.8% and 2.7%. The overall S. aureus colonization was negatively associated with the use of beta-lactams and of illicit drugs. On the other hand, MRSA colonized subjects were more likely to use crack and to have been admitted to a hospital during the past year. Repeated surveys found additional cases of MRSA colonization, but all subjects were positive in only one occasion. Four PFGE clusters were characterized, grouping subjects in household, city and region level. Of 19 total MRSA isolates, only one did not harbor SCCmec type IV. Spatial analysis detected hot spots of S. aureus colonized subjects from Botucatu, but that finding could not be linked to socio-economic indicators. In conclusion, we found small but relevant prevalence of MRSA among PLWHA. Community and healthcare-associated risk factors were identified, so that predominant routes of transmission could not be determined on epidemiological grounds.

O presente trabalho é resultado de uma parceria entre o Ministério da Agricultura, Pecuária e Abastecimento, a Agência Estadual de Defesa Agropecuária do Maranhão, a Universidade de São Paulo e a Universidade de Brasília, fazendo parte das atividades do Programa Nacional de Controle e Erradicação da Brucelose e Tuberculose Animal. Realizou-se um estudo do tipo transversal para estimar a prevalência da brucelose bovina em animais e propriedades no Maranhão e em quatro circuitos produtores de bovinos, oriundos da divisão do estado. Em cada propriedade selecionada para o estudo, foram aleatoriamente coletadas amostras de soro de fêmeas bovinas com idade igual ou superior a 24 meses, assim como, foi aplicado um questionário epidemiológico objetivando caracterizar os tipos de criação de bovinos e determinar os fatores de risco associados à ocorrência da doença no Maranhão. No total foram amostradas 749 propriedades e 6.779 animais. As coordenadas geográficas de cada propriedade foram coletadas para identificação da distribuição espacial das propriedades positivas e de áreas geográficas onde medidas de controle da doença devem ser preferencialmente implementadas. A prevalência de propriedades positivas com, ao menos um animal reagente, foi estimada em 11,42% (9,23 - 14,06%) e a prevalência de animais soropositivos foi de 2,52% (1,73 - 3,65%). Diferenças significativas de prevalência foram observadas entre o circuito produtor 2 e os demais circuitos. As variáveis: rebanho bovino com mais de 54 fêmeas com idade &ge; 24 meses, aluguel de pastos de/para terceiros e presença de áreas alagadiças na propriedade, foram identificadas como fatores de risco para a ocorrência de brucelose no estado. Exploração de corte foi identificada como um fator protetor da doença. A performance do modelo final de fatores de risco, analisada através da área sob a curva ROC, apresentou um valor igual a 0,73, o que significa dizer que a ocorrência de focos da doença é também influenciada por outros elementos não incluídos na análise de fatores de risco. A distribuição de brucelose bovina foi estudada através de análises espaciais de prevalência e efeitos de primeira e segunda ordem. Observou-se uma distribuição heterogênea de focos da doença no estado, com destaque para áreas no centro e nas fronteiras leste e noroeste. Pequenas evidências de efeitos de segunda ordem foram observados na escala de 0 a 10 km. A análise de efeitos de primeira ordem, através dos resíduos do modelo de regressão logística, identificou áreas de maior risco da doença, principalmente no centro do estado, onde a presença de brucelose bovina não foi totalmente explicada pelo modelo de fatores de risco. Maior atenção deva ser preferencialmente prestada a esta área, onde investigações epidemiológicas e intervenções de controle da doença devem ser implementadas. / The present work is the result of a partnership among the Ministry of Agriculture, Livestock and Food Supply, the Animal Health State Agency of Maranhão, the University of São Paulo and the University of Brasília, becoming part of the activities of the National Program to Control and Eradicate Animal Brucellosis and Tuberculosis. A cross-sectional study was conducted to estimate the prevalence of bovine brucellosis in animals and farms in Maranhão State and four cattle production circuits, from the arbitrary division of the State. In each farm selected for the study, serum samples were randomly collected from cows aged 24 months or more, as well as an epidemiological questionnaire was applied aiming to characterize the types of cattle production systems and to determine the risk factors associated with occurrence of the disease in Maranhão. In total 749 farms and 6,779 animals were surveyed. Geographic coordinates of each farm were collected for identification of the spatial distribution of positive farms and identification of geographic areas where disease control measures should preferably be implemented. The prevalence of positive farms with at least one reagent animal, was estimated at 11.42% (9.23 - 14.06%) and the prevalence of seropositive animals was 2.52% (1.73 - 3.65% ). Significant differences in prevalence were observed among the circuit number 2 and the others. The variables: cattle herd over 54 cows aged 24 months or more, rent pasture from/to third parties and presence of wetlands on the farm were identified as risk factors for the occurrence of brucellosis in the State. Beef herd was identified as a protective factor of the disease. The performance of the final model of risk factors, analyzed by the area under the ROC curve, was 0.73, which means that the occurrence of disease outbreaks is also influenced by other factors not included in the risk factors analysis. The distribution of bovine brucellosis was studied beyond spatial analysis of prevalence and first and second order effects. An heterogeneous distribution of disease outbreaks in the State was observed, especially some areas in central and eastern and northwestern borders. Little evidence of second order effects were observed on a scale of 0 to 10 km. The analysis of first-order effect, through the residues of the logistic regression model, identified areas of greatest risk of disease, especially in the center of the State, where the presence of bovine brucellosis has not been fully explained by the risk factors model. Greater attention should preferably be paid to this area, where epidemiological investigations and disease control interventions should be implemented.

L'évaluation des performances des méthodes de détection d'agrégats de maladie est fondamentale dans le domaine de l'épidémiologie spatiale et, paradoxalement, on déplore une absence de consensus quant à sa conduite. Cette problématique est d'autant plus importante que les nouvelles technologies de partage d'informations promettent une évolution importante des signaux disponibles pour l'épidémiologie et la veille sanitaire. Les spécialistes du domaine ont adopté un mode d'évaluation fondé sur l'utilisation concomitante de plusieurs indicateurs de performances complémentaires tels que des indicateurs dérivés de l'évaluation des méthodes diagnostiques ou encore diverses définitions de puissance conditionnelle. Cependant, ces évaluations issues de schémas de simulation classiques reposent sur le choix de quelques hypothèses alternatives particulières et ne permettent qu'une interprétation limitée à ces hypothèses. De plus, la démultiplication des indicateurs évaluant la performance, différents selon les protocoles, gêne la comparaison des études entres elles et complique l'interprétation des résultats. Notre travail propose et évalue plusieurs indicateurs de performance prenant en compte à la fois puissance et précision de localisation. Leur intérêt dans l'évaluation spatiale systématique des méthodes est illustré par la création de cartes de performance. En complément de l'évaluation des performances lorsqu'une détection est attendue, nous proposons également une méthode d'évaluation de la répartition spatiale de l'erreur de type I complétée par la construction d'une nouvelle inférence statistique testant l'éventualité d'un effet de bord. / Although performance assessment of cluster detection tests is a critical issue in spatial epidemiology, there is a lack of consensus regarding how it should be carried out. Nowadays, with the spread of new technologies in network systems, data sources for epidemiology are undergoing radical changes that will increase the need for performance evaluation. Field specialists are currently evaluating cluster detection tests with multiple complementary performance indicators such as conditional powers or indicators derived from the field of diagnostic tools evaluation. These evaluations are performed following classical protocols for power assessment and are often limited to a few number of simulated alternative hypotheses, thus restricting results interpretation and scope. Furthermore, with the use of multiple varying indicators, comparisons between studies is difficult at best. This work proposes and compares different global performance indicators that take into account both usual power and location accuracy. Their benefit for cluster detection tests evaluation is illustrated with a systematic spatial assessment enabling performance mapping. In addition to the evaluation of performance when clusters exist, we also propose a method for the spatial evaluation of type I error, together with a new statistical test for edge effect.

Use of spatial data has become an important aspect of data analysis. Use of location information can provide useful insight into the dataset. Advancement of sensor technologies and improved data connectivity have made it possible to the generation of large amounts of passively generated user location data. Apart from passively generated data from users, explicit effort has been made by commercial vendors to curate large amounts of location related data such as residential histories from a variety of sources such as credit records, litigation data, driving license records etc. Such spatial data, when linked with other datasets can provide useful insights. In this dissertation, we show that spatial information of data enables us to derive useful insights in domains of text analysis and epidemiology. We investigated primarily two types of data having spatial information - text data with location information and disease related data having residential address information. We show that in the case of text data, spatial information helps us find spatially informative topics. In the case of epidemiological data, we show residential information can be used to identify high risk spatial regions. There are instances where a primary analysis is not sufficient to establish a statistically robust conclusion. For instance, in domains such as epidemiology, where a finding is not considered to be relevant unless some statistical significance is established. We proposed techniques for significant tests which can be applied to text analysis, topic modelling, and disease mapping tasks in order to establish significance of the findings. / Computer and Information Science

No description available.

Emerging infectious diseases continue to threaten human health and healthcare resources across the world, and with the sustained emergence of some like Lyme disease, this trend is only expected to get worse. Even though some research has examined the spread of Lyme disease in different parts of the United States, focusing on its origin, spread, surveillance, and reporting, there has been minimal research on the recent spread of Lyme disease into and within Central and Southern Appalachia. This is an important gap, considering that this region is at the edge of the disease's expanding incidence and range. Considering this factor and the consequences that this disease may have on the residents of Appalachia who already face an array of underlying problems like chronic conditions, decreased access to health care, and exposure through outdoor work like resource extraction, addressing this gap will be important in understanding the current and future spatial range and impacts of the continued emergence of Lyme disease in Appalachia. This study thus sought to examine the extent of the emergence of Lyme disease in Appalachia between 2000 and 2019 using spatial scan statistic. This type of analysis uses spatiotemporal information to quantify disease emergence and diffusion using retrospective case and location data within a GIS environment; hence it helped quantify the spatial distribution and diffusion of Lyme disease into and within Appalachia and identify additional areas that can be targeted with public health prevention measures. We found five statistically significant clusters of Lyme disease across the contiguous US, indicating that the disease expanded spatially over the study period. Lyme disease has more than tripled across the US, with the number of counties with RR>1 increasing from 130 in 2000 to 453 by 2019. Lyme disease also increased more than eightfold in Appalachia, with spread southwards into and within Appalachia. The number of Appalachian counties with RR>1 increased from 16 in 2000 to 127 in 2019. These findings are important in understanding the current and future spatial range and the impacts of the continued emergence of Lyme disease in Appalachia. With this understanding, we can minimize the misdiagnosis of Lyme disease and inform public health action to reduce public vulnerability. / Master of Science / Emerging infectious diseases are diseases that have not been present, the persistence of diseases that were previously unknown, or those diseases that are rapidly increasing in a given location. These diseases continue to threaten human health and healthcare resources across the world, and with the sustained emergence of some like Lyme disease, this trend is only expected to get worse. Even though some research has investigated the spread of Lyme disease in different parts of the United States, focusing on its origin, spread, monitoring, and reporting, there has been minimal research on the recent spread of Lyme disease in Central and Southern Appalachia. This is an important gap, considering that this region is next to areas where the disease has recently spread, thereby making it vulnerable to continued spread. Considering this factor and the consequences that this disease may have on the residents of Appalachia who already face many underlying problems like long-term conditions, decreased access to health care, and exposure through outdoor work like resource extraction, addressing this gap will be important in understanding the current and future geographic occurrence and impacts of the continued spread of Lyme disease in Appalachia. This study thus sought to investigate the extent of the spread of Lyme disease in Appalachia between 2000 and 2019 using statistics and identification of places with a higher than expected number of cases. This type of analysis uses location information to quantify disease occurrence and spread using past case and location data using GIS software; hence it helped identify the distribution and spread of Lyme disease into and within Appalachia and identify additional areas that can be targeted with public health prevention measures. We found five areas with higher than expected number of Lyme disease cases across the contiguous US, indicating that the disease increased over the study period. Lyme disease has more than tripled across the US, with the number of counties with higher cases than expected increasing from 130 in 2000 to 453 by 2019. Lyme disease also increased more than eightfold in Appalachia, with spread southwards into and within Appalachia. The number of Appalachian counties with higher than expected Lyme disease cases increased from 16 in 2000 to 127 in 2019. These findings are important in understanding the current and future spread and the impacts of this continued spread of Lyme disease in Appalachia. With this understanding, we can properly detect Lyme disease and inform public health action to reduce public vulnerability.

The Safe Drinking Water Act (SDWA) was established to protect consumers from potential exposure to over 90 water contaminants. Each contaminant is assigned a health-based standard meant to reflect the maximum level at which an adverse human health outcome is unlikely; measurements beyond that level have greater potential to result in an adverse health outcome. While extensive research has been done on the human health implications of water contaminants, few studies have specifically examined the risk to fetal health under real world monitoring conditions. Therefore, the objective of this study is to assess whether drinking water violations are related to fetal health in the Commonwealth of Virginia, by examining the association between SDWA violations and preterm birth (PTB), low birth weight (LBW), and term-low birth weight (tLBW). Singleton births (n=665,984) occurring between 2007 and 2015 in Virginia were geocoded and assigned to their corresponding water service area. Health-based (HB) and monitoring and reporting (MR) violations for 12 contaminants were acquired from the USEPA Safe Drinking Water System, and exposure to contaminants was defined at the service area level to limit exposure misclassification. A logistic regression model for each birth outcome was performed to evaluate potential relationships with water contaminants. When examining the relationship between individual monitoring and reporting violations and PTB, Nitrate-Nitrite and Disinfectant Byproducts Stage 2 violations were both positively associated with the birth outcome. When examining the relationship between health-based violations and birth outcomes, the total coliform rule was negatively associated with tLBW. These findings indicate that monitoring and reporting requirements may need to be more stringent to reduce MR violation occurrence. / Master of Science / The Safe Drinking Water Act (SDWA) was established to protect consumers from potential exposure to over 90 water contaminants. Each contaminant is assigned a health-based standard, called the maximum contaminant level (MCL), meant to reflect the maximum level at which an adverse human health outcome is unlikely; measurements beyond that level have greater potential to result in an adverse health outcome. If a contaminant exceeds the MCL or if the water system fails to treat contaminants, then a health-based violation is issued. These health-based violations are a good indication of the water quality within a public water system. In addition to meeting these health-based requirements, public water systems are required to perform regular monitoring and reporting. When a system fails to evaluate water samples or report results, a monitoring and reporting violation is issued. While extensive research has been done on the human health implications of water contaminants, few studies have specifically examined the risk to fetal health under real world monitoring conditions. Therefore, the objective of this study is to assess whether drinking water violations (health-based and monitoring and reporting) are related to fetal health in the Commonwealth of Virginia, by examining the association between SDWA violations and preterm birth (PTB), low birth weight (LBW), and term-low birth weight (tLBW). Singleton births (n=665,984) occurring between 2007 and 2015 in Virginia were geocoded and assigned to their corresponding water service area. Health-based and monitoring and reporting (MR) violations for 12 contaminants were acquired from the USEPA Safe Drinking Water Information System, and exposure to contaminants was defined at the service area level to limit exposure misclassification. A logistic regression model for each birth outcome was performed to evaluate potential relationships with water contaminants. When examining the relationship between individual monitoring and reporting violations and PTB, Nitrate-Nitrite and Disinfectant Byproducts Stage 2 violations were both positively associated with PTB. When examining the relationship between health-based violations and birth outcomes, the total coliform rule was negatively associated with tLBW. These findings indicate that monitoring and reporting requirements may need to be more stringent to reduce MR violation occurrence.

Orientador: Carlos Magno Castelo Branco Fortaleza / Resumo: A resistência microbiana causa grande número de mortes todos os anos. Sua emergência e disseminação são fenômenos complexos, que devem ser compreendidos no contexto de redes de assistência. Entre os microrganismos multidroga-resistentes (MDR), causam especial preocupação os bacilos Gram-negativos, especialmente Acinetobacter baumannii e Enterobactérias (Escherichia coli, Klebsiella spp e Enterobacter spp) resistentes aos carbapenêmicos (CRAB e CRE, respectivamente). Nós realizamos dois estudos com o objetivo de descrever o comportamento espaço-temporal de CRAB e CRE. O primeiro deles teve delineamento ecológico e se baseou em notificações de agentes de infecção da corrente sanguínea em Unidades de Terapia Intensiva do Estado de São Paulo. O segundo foi uma revisão sistemática de literatura científica e “literatura cinzenta” para identificar relatos de ocorrência de infecções por CRAB e CRE no Brasil. Nossos resultados no Estado de São Paulo demonstraram tendências temporais opostas para CRAB (redução) e CRE (crescimento). Em ambos os casos a incidência é maior nas Regiões Metropolitanas de São Paulo e Campinas, a partir de onde os microrganismos parecem espalhar-se para outras áreas. Infecções foram mais frequentes em hospitais públicos e naqueles com menor proporção de leitos de UTI. Fatores socio-econômicos e demográficos apresentaram associações variáveis, porém plausíveis, com a incidência dos microrganismos de interesse. Os resultados da revisão sistemática apontam para ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Antimicrobial resistance causes great numbers of deaths every year. Its emergence and dissemination are complex phenomena, which must be understood in the context of healthcare networks. Among multidrug-resistant microorganisms (MDR), carbapenem-resistant Gram-negative bacilli, especially Acinetobacter baumannii (CRAB) and Enterobacteriaceae (Escherichia coli, Klebsiella spp and Enterobacter spp; CRE) are of special concern. We performed two studies with the objective of describing the space-time behavior of CRAB and CRE. The first study had an ecological design and was based on reports of microorganisms causing bloodstream infections in Intensive Care Units in the São Paulo State, Brazil. The second was a systematic review of scientific literature and "gray literature" to identify reports of CRAB and CRE infections in Brazil. Our results in the State of São Paulo showed opposite temporal trends for CRAB (reduction) and CRE (growth). In both cases the incidence is higher in the Metropolitan Regions of São Paulo and Campinas, from where the microorganisms seem to spread to other areas. Infections were more frequent in public hospitals and in those with a lower proportion of ICU beds. Socio-economic and demographic factors presented variable but plausible associations with the incidence of microorganisms of interest. Results of the systematic review point to an initial concentration of CRAB and CRE reports in the Brazilian Southeast, followed by a dispersion in the country. The... (Complete abstract click electronic access below) / Doutor

Orientador: Carlos Magno Castelo Branco Fortaleza / Resumo: Staphylococcus aureus resistente à meticilina (Methicillin-resistant S. aureus, MRSA) é cada vez mais reconhecido como uma ameaça para pessoas vivendo com HIV/AIDS (PVHA). No entanto, a magnitude da colonização por MRSA varia entre diferentes países e regiões geográficas. Nós realizamos um estudo que teve por objetivo identificar a prevalência e os fatores de risco para colonização por S. aureus como um todo e MRSA em PVHA residindo em cidades de pequeno porte do interior do Estado de São Paulo. Isolados de MRSA foram caracterizados por Eletroforese em Gel de Campo Pulsado (Pulsed-Field Gel Electrophoresis, PFGE) e tiveram o Cassete Cromossômico Estafilocóccico (Staphylococcal Chromosome Cassete, SCC) mec tipado. Análise espacial foi realizada para identificar agregados geográficos e correlação com indicadores socioeconômicos. No primeiro momento, realizamos um estudo de prevalência pontual coletando swab nasal e de orofaringe de 368 PVHA atendidas em ambulatório de referência em Botucatu, SP. Sessenta e sete sujeitos residentes na cidade sede foram seguidos com coletas em dois outros momentos, e tiveram seus contactantes domiciliares também investigados para colonização. As taxas de prevalência de S. aureus e MRSA no primeiro levantamento foram 25,8% e 2,7%. A colonização por S. aureus foi negativamente associada com o uso de antibióticos beta-lactâmicos e drogas ilícitas. Por outro lado, fatores de risco para MRSA incluíam uso de crack e internação hospitalar recente. Inqué... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Methicillin-resistant Staphylococcus aureus (MRSA) is increasingly recognized as a threat for people living with HIV/AIDS (PLWHA). However, the magnitude of asymptomatic MRSA colonization in that group varies among different countries and geographic regions. We conducted a study that aimed at identifying the prevalence and risk factors for both overall S. aureus and MRSA colonization among PLWHA attending in small cities from inner São Paulo State, Brazil. MRSA isolates were characterized using Pulsed-Field Gel Electrophoresis (PFGE), and submitted to typing of the Staphylococcal Chromosome Cassete (SCC)mec. Spatial analysis was performed to search for geographical clusters and correlation with socioeconomic indicators. In a first point prevalence survey, nasal and oropharyngeal swabs of 368 people were collected. Sixty-seven subjects from the main city (Botucatu) were surveyed for colonization in two other occasions, and had swabs collected from household members. The prevalence rates for S. aureus and MRSA in the first survey were 25.8% and 2.7%. The overall S. aureus colonization was negatively associated with the use of beta-lactams and of illicit drugs. On the other hand, MRSA colonized subjects were more likely to use crack and to have been admitted to a hospital during the past year. Repeated surveys found additional cases of MRSA colonization, but all subjects were positive in only one occasion. Four PFGE clusters were characterized, grouping subjects in household, ... (Complete abstract click electronic access below) / Mestre