IntroductionSelf-reported tobacco use in the United Arab Emirates is among the highest in the region. Use of tobacco products other than cigarettes is widespread, but little is known about specific behavior use patterns. There have been no studies that have biochemically verified smoking status.MethodsThe UAE Healthy Future Study (UAEHFS) seeks to understand the causes of non-communicable diseases through a 20,000-person cohort study. During the study pilot, 517 Emirati nationals were recruited to complete a questionnaire, provide clinical measurements and biological samples. Complete smoking data were available for 428 participants. Validation of smoking status via cotinine testing was conducted based on complete questionnaire data and matching urine samples for 399 participants, using a cut-off of 200ng/ml to indicate active smoking status.ResultsSelf-reported tobacco use was 36% among men and 3% among women in the sample. However, biochemical verification of smoking status revealed that 42% men and 9% of women were positive for cotinine indicating possible recent tobacco use. Dual and poly-use of tobacco products was fairly common with 32% and 6% of the sample reporting respectively.ConclusionsThis is the first study in the region to biochemically verify tobacco use self-report data. Tobacco use in this study population was found to be higher than previously thought, especially among women. Misclassification of smoking status was more common than expected. Poly-tobacco use was also very common. Additional studies are needed to understand tobacco use behaviors and the extent to which people may be exposed to passive tobacco smoke.ImplicationsThis study is the first in the region to biochemically verify self-reported smoking status.

Where a licence is displayed above, please note the terms and conditions of the licence govern your use of this document.When citing, please reference the published version. Take down policyWhile the University of Birmingham exercises care and attention in making items available there are rare occasions when an item has been uploaded in error or has been deemed to be commercially or otherwise sensitive.

Network (CDN) launched a research and learning collaborative project with six community health centers in the New York City metropolitan area to determine the nature (clonal type) of community-acquired Staphylococcus aureus strains causing skin and soft tissue infections (SSTIs). Between November 2011 and March 2013, wound and nasal samples from 129 patients with active SSTIs suspicious for S. aureus were collected and characterized by molecular typing techniques. In 63 of 129 patients, the skin wounds were infected by S. aureus: methicillinresistant S. aureus (MRSA) was recovered from 39 wounds and methicillin-sensitive S. aureus (MSSA) was recovered from 24. Most-46 of the 63-wound isolates belonged to the CC8/Panton-Valentine leukocidin-positive (PVL ؉ ) group of S. aureus clone USA300: 34 of these strains were MRSA and 12 were MSSA. Of the 63 patients with S. aureus infections, 30 were also colonized by S. aureus in the nares: 16 of the colonizing isolates were MRSA, and 14 were MSSA, and the majority of the colonizing isolates belonged to the USA300 clonal group. In most cases (70%), the colonizing isolate belonged to the same clonal type as the strain involved with the infection. In three of the patients, the identity of invasive and colonizing MRSA isolates was further documented by whole-genome sequencing. Staphylococcus aureus is the most common cause of bacterial infections in humans worldwide (1), and methicillin-resistant Staphylococcus aureus (MRSA) is the main cause of skin and soft tissue infections (SSTIs) in North America, with a single clone, USA300, accounting for 98% of these infections (2, 3).The first human case of MRSA infection in the United States was reported in Boston, MA, in 1968 (4). MRSA was first detected in hospitals, and over the following decades, it became the main nosocomial pathogen around the world (5). In 1998, the prevalence of MRSA in 12 hospitals throughout the city of New York was assessed (6), and a single MRSA clone was found to be responsible for an overwhelming majority of MRSA infections. The same MRSA clone was subsequently identified as dominant in MRSA infections in 29 hospitals in the tristate area (7), and it was also identified in MRSA infections in Japan (8). This MRSA clone (multilocus sequence typing [MLST] clonal complex CC5, sequence type ST5, SCCmecII, and unique pulsed-field gel electrophoresis [PFGE] profile)-also known as the "New York/Japan clone" or "MRSA clone USA100"-became the most prevalent MRSA clone involved in MRSA infections in hospitals in the United States in the 1990s (9).In 1993, a new MRSA clone emerged in Kimberley, Western Australia (10), in a community of patients without previous health care contact (community-acquired MRSA [CA-MRSA]). In the late 1990s, CA-MRSA also appeared in the United States and was responsible for the death of four otherwise healthy pediatric patients in Minnesota and North Dakota (11). These new CA-MRSA strains belonged to a clone (USA400/CC1/SCCmecIV)

Supplemental Digital Content is available in the text.