Increasing Rates of Hospitalization Due to Septicemia in the US Elderly Population, 1986–1997

Abstract

Rates of hospitalization due to septicemia (International Classification of Diseases, Ninth Revision, Clinical Modification, code 038) in the US elderly population for 1986-1997 were examined, using Medicare administrative data. Age group-, sex-, and race-adjusted rates more than doubled from 1986 through 1997, from 3.42 to 7.42 per 1000 beneficiaries. The 1997 rates of septicemia increased with age, from 4.47 per 1000 beneficiaries among persons 65-74 years old to 18.1 per 1000 beneficiaries among persons > or =85 years old. The rates of septicemia were slightly greater among men (7.46 per 1000 beneficiaries) than among women (7.39 per 1000 beneficiaries) and were higher among blacks (13.61 per 1000 beneficiaries) than among whites (6.89 per 1000 beneficiaries). The most likely sites of the origin of the septicemia were the urinary tract (40.1%) and lungs (15.3%). Escherichia coli and Staphylococcus species were the most frequently reported organisms. Diabetes was listed as a comorbidity in 24.5% of the hospitalizations. We estimate that the cost to Medicare for septicemia hospitalizations in 1997 was >$1.8 billion.

Incidence of and risk factors for bacteraemia in HIV-infected adults in the era of highly active antiretroviral therapy

“…Descriptive analyses of the demographic and clinical characteristics of the study patients were conducted, including gender, age (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)30-39, 40-49 and 50 years), race/ethnicity (White non-Hispanic, Black nonHispanic, Hispanic, other, or missing), HIV transmission risk factor, CD4 count (o50, 51-200, 201-350, 351-500 or 4500 cells/mL), HIV-1 RNA ( 400, 401-1000, 1001-10 000, 10 001-100 000 or 4100 000 HIV-1 RNA copies/ mL), receipt of HAART and insurance. To retain patients in analyses, categories of 'missing' were included for race, risk factor, insurance, CD4 cell count and HIV-1 RNA.…”

Epidemiología de la sepsis en unidades de cuidado intensivo en Colombia

“…More recent studies have estimated annual increases of up to 10% (36,37). Gender, diabetes, immunosuppression, and cancer are among the factors associated with these increases.…”

A killed, genetically engineered derivative of a wild-type extraintestinal pathogenic E. coli strain is a vaccine candidate

“…Despite a recent emphasis on Gram-positive bacterial infections, Gram-negative bacterial infections, especially those due to extraintestinal pathogenic E. coli (ExPEC), continue to be extremely important. ExPEC are the most common enteric Gram-negative organisms to cause extraintestinal infection in the ambulatory, long-term-care, and hospital settings [1][2][3][4][5]. Typical extraintestinal infections due to E. coli include urinary tract infection, diverse intra-abdominal infections, pneumonia, surgical site infection, meningitis, intra-vascular device infection, osteomyelitis, and soft tissue infections, any of which can be accompanied by bacteremia and sepsis [6].…”

“…Typical extraintestinal infections due to E. coli include urinary tract infection, diverse intra-abdominal infections, pneumonia, surgical site infection, meningitis, intra-vascular device infection, osteomyelitis, and soft tissue infections, any of which can be accompanied by bacteremia and sepsis [6]. Sepsis is ranked as the tenth overall cause of death in the U.S. [7] and by using the conservative estimate that E. coli causes 17% of cases of severe sepsis [1,8,9], severe sepsis due to E. coli (the leading etiologic agent) was associated with an estimated 40,000 deaths in 2001.…”

“…In addition, a significant minority of extraintestinal E. coli isolates from long-term care facilities and hospitals in the U.S. already have acquired plasmids encoding extended spectrum ß-lactamases that confer resistance to 3 rd generation cephalosporins, and aztreonam, and frequently contain linked resistance determinants for aminoglycosides, tetracyclines, and trimethoprimsulfamethoxasole. Furthermore, the incidence of serious extraintestinal infection due to E. coli increases with age [1,13]. As the proportion of elderly patients increases in the U.S. and other developed countries, so likely will the number of extraintestinal E. coli infections.…”