Journal article
Invasive Haemophilus influenzae in the United States, 1999–2008: Epidemiology and outcomes
The Journal of infection, Vol.65(6), pp.496-504
12/2012
DOI: 10.1016/j.jinf.2012.08.005
PMCID: PMC4329643
PMID: 22902945
Abstract
Introduction of the Haemophilus influenzae type b (Hib) conjugate vaccine has resulted in a dramatic reduction of Hib disease in the U.S. and an increase in the relative importance of infections caused by nontypeable strains. The current project describes the characteristics and clinical outcomes of pediatric and adult patients with invasive H. influenzae (HI) and, through multivariable analysis, identifies risk factors for in-hospital mortality.
HI cases were identified during 1999–2008 through active surveillance as part of Active Bacterial Core surveillance (ABCs). Multivariable analysis was performed with logistic regression to identify factors predictive of in-hospital death.
4839 cases of HI were identified from 1999–2008. Children accounted for 17.1% of cases and adults 82.9%. Underlying conditions were present in 20.7% of children and 74.8% of adults. In-hospital mortality was highest in cases ≥65 years (21.9%) and <3 months (16.2%).
The risk of in-hospital death in children <1 year was higher among those who were prematurely-born (<28 weeks, OR 7.1, 95% CI 3.2–15.6; 28–36 weeks OR 2.1, 95% CI 0.9–4.8) and, among children aged 1–17 years, higher in those with healthcare-associated onset and dialysis (OR 5.66, 95% CI 1.84–17.39; OR 18.11, 95% CI 2.77–118.65). In adults, age ≥40 was associated with death in nontypeable, but not encapsulated, infections. Infections with nontypeable strains increased the risk of death in cases ≥65 years (OR 1.81, 95% CI 1.31–2.52). Healthcare-associated HI, bacteremia without identifiable focus, bacteremic pneumonia, associated cirrhosis, cerebrovascular accident, dialysis, heart failure, and non-hematologic malignancy also increased the risk of death in adults.
Prematurity in infants, advanced age and certain chronic diseases in adults were associated with an increased risk of in-hospital death. Nontypeable HI was associated with higher mortality in the elderly.
Details
- Title: Subtitle
- Invasive Haemophilus influenzae in the United States, 1999–2008: Epidemiology and outcomes
- Creators
- Daniel J Livorsi - Department of Medicine, Emory University School of Medicine, The Atlanta VA Medical Center, 1670 Clairmont Road, Mail Code 151-ID, Atlanta, GA 30333, USAJessica R MacNeil - Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, USAAmanda C Cohn - Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, USAJoseph Bareta - New Mexico Department of Health, USAShelly Zansky - New York State Department of Health, USASusan Petit - Connecticut Department of Public Health, USAKen Gershman - Colorado Department of Public Health and Environment, USALee H Harrison - Department of International Health, Johns Hopkins Bloomberg School of Public Health, USARuth Lynfield - Minnesota Department of Health, USAArthur Reingold - School of Public Health, University of California, Berkley, USAWilliam Schaffner - Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN, USAAnn Thomas - Oregon Department of Human Services, USAMonica M Farley - Department of Medicine, Emory University School of Medicine, The Atlanta VA Medical Center, 1670 Clairmont Road, Mail Code 151-ID, Atlanta, GA 30333, USA
- Resource Type
- Journal article
- Publication Details
- The Journal of infection, Vol.65(6), pp.496-504
- DOI
- 10.1016/j.jinf.2012.08.005
- PMID
- 22902945
- PMCID
- PMC4329643
- NLM abbreviation
- J Infect
- ISSN
- 0163-4453
- eISSN
- 1532-2742
- Publisher
- Elsevier Ltd
- Language
- English
- Date published
- 12/2012
- Academic Unit
- Infectious Diseases; Internal Medicine
- Record Identifier
- 9984094315202771
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