Population-based laboratory assessment of the burden of community-onset bloodstream infection in Victoria, Canada

SUMMARYAlthough community-onset bloodstream infection (BSI) is recognized as a major cause of morbidity and mortality, its epidemiology has not been well defined in non-selected populations. We conducted population-based laboratory surveillance in the Victoria area, Canada during 1998–2005 in order to determine the burden associated with community-onset BSI. A total of 2785 episodes were identified for an overall annual incidence of 101·2/100 000. Males and the very young and the elderly were at highest risk. Overall 1980 (71%) episodes resulted in hospital admission for a median length of stay of 8 days; the total days of acute hospitalization associated with community-onset BSI was 28 442 days or 1034 days/100 000 population per year. The in-hospital case-fatality rate was 13%. Community-onset BSI is associated with a major burden of illness. These data support ongoing and future preventative and research efforts aimed at reducing the major impact of these infections.

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Burden of community-onset bloodstream infection: a population-based assessment

Epidemiology and Infection ◽

10.1017/s0950268806007631 ◽

2006 ◽

Vol 135 (6) ◽

pp. 1037-1042 ◽

Cited By ~ 71

Author(s):

K. B. LAUPLAND ◽

D. B. GREGSON ◽

W. W. FLEMONS ◽

D. HAWKINS ◽

T. ROSS ◽

...

Keyword(s):

Bloodstream Infection ◽

Case Fatality Rate ◽

Case Fatality ◽

Population Based ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Societal Impact ◽

Acute Hospitalization ◽

Laboratory Surveillance ◽

Community Onset

SUMMARYAlthough community-onset bloodstream infection (BSI) is recognized to be a major cause of morbidity and mortality, there is a paucity of population-based studies defining its overall burden. We conducted population-based laboratory surveillance for all community-onset BSI in the Calgary Health Region during 2000–2004. A total of 4467 episodes of community-onset BSI were identified for an overall annual incidence of 81·6/100 000. The three species,Escherichia coli,Staphylococcus aureus, andStreptococcus pneumoniaewere responsible for the majority of community-onset BSI; they occurred at annual rates of 25·8, 13·5, and 10·1/100 000, respectively. Overall 3445/4467 (77%) episodes resulted in hospital admission representing 0·7% of all admissions to major acute care hospitals. The subsequent hospital length of stay was a median of 9 (interquartile range, 5–15) days; the total days of acute hospitalization attributable to community-onset BSI was 51 146 days or 934 days/100 000 annually. Four hundred and sixty patients died in hospital for a case-fatality rate of 13%. Community-onset BSI is common and has a major patient and societal impact. These data support further efforts to reduce the burden of community-onset BSI.

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Occurrence and determinants of Klebsiella species bloodstream infection in the western interior of British Columbia, Canada

10.21203/rs.2.14157/v2 ◽

2019 ◽

Author(s):

Connor B. Reid ◽

Lisa Steele ◽

Kelsey Pasquill ◽

Elizabeth C. Parfitt ◽

Kevin Laupland

Keyword(s):

British Columbia ◽

Bloodstream Infection ◽

Burden Of Illness ◽

Case Fatality ◽

Population Based ◽

Hospital Length ◽

Interquartile Range ◽

Chronic Obstructive ◽

Klebsiella Species ◽

Obstructive Pulmonary Disease

Abstract BACKGROUND: Klebsiella species are among the most common causes of bloodstream infection (BSI). However, few studies have evaluated their epidemiology in non-selected populations. The objective was to define the incidence of, risk factors for, and outcomes from Klebsiella species BSI among residents of the western interior of British Columbia, Canada. METHODS: Population-based surveillance was conducted between April 1, 2010 and March 31, 2017. RESULTS: 151 episodes were identified for an incidence of 12.1 per 100,000 population per year; the incidences of K. pneumoniae and K. oxytoca were 9.1 and 2.9 per 100,000 per year, respectively. Overall 24 (16%) were hospital-onset, 90 (60%) were healthcare-associated, and 37 (25%) were community-associated. The median patient age was 71.4 (interquartile range, 58.8-80.9) years and 88 (58%) cases were males. Episodes were uncommon among patients aged 40 years old and no cases were observed among those aged 10 years. A number of co-morbid medical illnesses were identified as significant risks and included (incidence rate ratio; 95% confidence interval) cerebrovascular accident (5.9; 3.3-9.9), renal disease 4.3; 2.5-7.0), cancer (3.8; 2.6-5.5), congestive heart failure (3.5; 1.6-6.6), dementia (2.9; 1.5-5.2), diabetes mellitus (2.6; 1.7-3.9), and chronic obstructive pulmonary disease (2.3; 1.5-3.5). Of the 141 (93%) patients admitted to hospital, the median hospital length stay was 8 days (interquartile range, 4-17). The in-hospital and 30-day all cause case-fatality rates were 24/141 (17%) and 27/151 (18%), respectively. CONCLUSIONS: Klebsiella species BSI is associated with a significant burden of illness particularly among those with chronic co-morbid illnesses.

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Occurrence and determinants of Klebsiella species bloodstream infection in the western interior of British Columbia, Canada

BMC Infectious Diseases ◽

10.1186/s12879-019-4706-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Connor B. Reid ◽

Lisa Steele ◽

Kelsey Pasquill ◽

Elizabeth C. Parfitt ◽

Kevin B. Laupland

Keyword(s):

British Columbia ◽

Bloodstream Infection ◽

Burden Of Illness ◽

Case Fatality ◽

Population Based ◽

Hospital Length ◽

Interquartile Range ◽

Chronic Obstructive ◽

Klebsiella Species ◽

Obstructive Pulmonary Disease

Abstract Background Klebsiella species are among the most common causes of bloodstream infection (BSI). However, few studies have evaluated their epidemiology in non-selected populations. The objective was to define the incidence of, risk factors for, and outcomes from Klebsiella species BSI among residents of the western interior of British Columbia, Canada. Methods Population-based surveillance was conducted between April 1, 2010 and March 31, 2017. Results 151 episodes were identified for an incidence of 12.1 per 100,000 population per year; the incidences of K. pneumoniae and K. oxytoca were 9.1 and 2.9 per 100,000 per year, respectively. Overall 24 (16%) were hospital-onset, 90 (60%) were healthcare-associated, and 37 (25%) were community-associated. The median patient age was 71.4 (interquartile range, 58.8–80.9) years and 88 (58%) cases were males. Episodes were uncommon among patients aged < 40 years old and no cases were observed among those aged < 10 years. A number of co-morbid medical illnesses were identified as significant risks and included (incidence rate ratio; 95% confidence interval) cerebrovascular accident (5.9; 3.3–9.9), renal disease 4.3; 2.5–7.0), cancer (3.8; 2.6–5.5), congestive heart failure (3.5; 1.6–6.6), dementia (2.9; 1.5–5.2), diabetes mellitus (2.6; 1.7–3.9), and chronic obstructive pulmonary disease (2.3; 1.5–3.5). Of the 141 (93%) patients admitted to hospital, the median hospital length stay was 8 days (interquartile range, 4–17). The in-hospital and 30-day all cause case-fatality rates were 24/141 (17%) and 27/151 (18%), respectively. Conclusions Klebsiella species BSI is associated with a significant burden of illness particularly among those with chronic co-morbid illnesses.

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Occurrence and determinants of Klebsiella species bloodstream infection in the western interior of British Columbia, Canada

10.21203/rs.2.14157/v1 ◽

2019 ◽

Author(s):

Connor B. Reid ◽

Lisa Steele ◽

Kelsey Pasquill ◽

Elizabeth C. Parfitt ◽

Kevin Laupland

Keyword(s):

British Columbia ◽

Bloodstream Infection ◽

Burden Of Illness ◽

Case Fatality ◽

Population Based ◽

Hospital Length ◽

Interquartile Range ◽

Chronic Obstructive ◽

Klebsiella Species ◽

Obstructive Pulmonary Disease

Abstract BACKGROUND Klebsiella species are among the most common causes of bloodstream infection (BSI). However, few studies have evaluated their epidemiology in non-selected populations. The objective was to define the incidence of, risk factors for, and outcomes from Klebsiella species BSI among residents of the western interior of British Columbia, Canada.METHODS Population-based surveillance was conducted between April 1, 2010 and March 31, 2017.RESULTS 151 episodes were identified for an incidence of 12.1 per 100,000 per year; the incidences of K. pneumoniae and K. oxytoca were 9.1 and 2.9 per 100,000 per year, respectively. Overall 24 (16%) were hospital-onset, 90 (60%) were healthcare-associated, and 37 (25%) were community-associated. The median patient age was 71.4 (interquartile range, 58.8-80.9) years and 88 (58%) cases were males. Episodes were uncommon among patients aged ≤40 years old and no cases were observed among those aged ≤ 10 years. A number of co-morbid medical illnesses were identified as significant risks and included (incidence rate ratio; 95% confidence interval) cerebrovascular accident (5.9; 3.3-9.9), renal disease 4.3; 2.5-7.0), cancer (3.8; 2.6-5.5), congestive heart failure (3.5; 1.6-6.6), dementia (2.9; 1.5-5.2), diabetes mellitus (2.6; 1.7-3.9), and chronic obstructive pulmonary disease (2.3; 1.5-3.5). Of the 141 (93%) patients admitted to hospital, the median hospital length stay was 8 days (interquartile range, 4-17). The in-hospital and 30-day all cause case-fatality rates were 24/141 (17%) and 27/151 (18%), respectively.CONCLUSIONS Klebsiella species BSI is associated with a significant burden of illness particularly among those with chronic co-morbid illnesses.

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Burden of severe illness associated with laboratory confirmed influenza in adults aged 50-64 years: a rapid review

10.22541/au.163871937.74680730/v1 ◽

2021 ◽

Author(s):

Dong Kim ◽

Allison McGeer ◽

Elizabeth Uleryk ◽

Brenda Coleman

Keyword(s):

Seasonal Influenza ◽

Burden Of Illness ◽

Grey Literature ◽

Case Fatality ◽

The Elderly ◽

Mortality Rates ◽

Population Based ◽

Rapid Review ◽

Severe Illness ◽

Vaccination Programs

Background: While the high burden of illness caused by seasonal influenza in children and the elderly is well-recognized, less is known about the burden in adults 50-64 years of age. The lack of data for this age group is a key challenge in evaluating the cost-effectiveness of vaccination programs. We aimed to assess influenza-associated hospitalization and mortality rates, and case fatality rates for hospitalized cases among adults aged 50-64 years. Methods: This review was conducted according to the PRISMA: we searched MEDLINE, EMBASE, Cochrane, Web of Science, and grey literature for articles and reports published since 2010. Studies reporting rates of hospitalization and/or mortality associated with laboratory-confirmed influenza among adults 50-64 or 45-64 years of age for the 2010-11 through 2019-20 seasons were included. Results: Twenty studies from 13 countries were included. Reported hospitalization rates associated with laboratory-confirmed influenza 5.7 to 112.8 per 100,000. Rates tended to be higher in 2015-2019 compared to 2010-2014, and were higher in studies reporting data from high income versus low and middle-income countries. Mortality rates were reported in only one study, with rates ranging from 0.8-3.5 per 100,000 in four different seasons. The case fatality rate among those hospitalized with influenza, as reported by population-based studies, ranged from 1.3% to 5.6%. Conclusions: Seasonal influenza imposes a significant burden of morbidity in adults 50-64 years of age, but with high heterogeneity across seasons and geographic regions. Ongoing surveillance is required to improve estimates of burden to better inform influenza vaccination and other public health policy.

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Occurrence and determinants of Klebsiella species bloodstream infection in the western interior of British Columbia, Canada

10.21203/rs.2.14157/v3 ◽

2019 ◽

Author(s):

Connor B. Reid ◽

Lisa Steele ◽

Kelsey Pasquill ◽

Elizabeth C. Parfitt ◽

Kevin Laupland

Keyword(s):

British Columbia ◽

Bloodstream Infection ◽

Burden Of Illness ◽

Case Fatality ◽

Population Based ◽

Hospital Length ◽

Interquartile Range ◽

Chronic Obstructive ◽

Klebsiella Species ◽

Obstructive Pulmonary Disease

Abstract BACKGROUND Klebsiella species are among the most common causes of bloodstream infection (BSI). However, few studies have evaluated their epidemiology in non-selected populations. The objective was to define the incidence of, risk factors for, and outcomes from Klebsiella species BSI among residents of the western interior of British Columbia, Canada.METHODS Population-based surveillance was conducted between April 1, 2010 and March 31, 2017.RESULTS 151 episodes were identified for an incidence of 12.1 per 100,000 population per year; the incidences of K. pneumoniae and K. oxytoca were 9.1 and 2.9 per 100,000 per year, respectively. Overall 24 (16%) were hospital-onset, 90 (60%) were healthcare-associated, and 37 (25%) were community-associated. The median patient age was 71.4 (interquartile range, 58.8-80.9) years and 88 (58%) cases were males. Episodes were uncommon among patients aged Common.EditSubmissionSteps.Transform.EquationText 40 years old and no cases were observed among those aged Common.EditSubmissionSteps.Transform.EquationText 10 years. A number of co-morbid medical illnesses were identified as significant risks and included (incidence rate ratio; 95% confidence interval) cerebrovascular accident (5.9; 3.3-9.9), renal disease 4.3; 2.5-7.0), cancer (3.8; 2.6-5.5), congestive heart failure (3.5; 1.6-6.6), dementia (2.9; 1.5-5.2), diabetes mellitus (2.6; 1.7-3.9), and chronic obstructive pulmonary disease (2.3; 1.5-3.5). Of the 141 (93%) patients admitted to hospital, the median hospital length stay was 8 days (interquartile range, 4-17). The in-hospital and 30-day all cause case-fatality rates were 24/141 (17%) and 27/151 (18%), respectively.CONCLUSIONS Klebsiella species BSI is associated with a significant burden of illness particularly among those with chronic co-morbid illnesses.

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Burden of community-onset bloodstream infections, Western Interior, British Columbia, Canada

Epidemiology and Infection ◽

10.1017/s0950268816000613 ◽

2016 ◽

Vol 144 (11) ◽

pp. 2440-2446 ◽

Cited By ~ 8

Author(s):

K. B. LAUPLAND ◽

K. PASQUILL ◽

E. C. PARFITT ◽

P. NAIDU ◽

L. STEELE

Keyword(s):

British Columbia ◽

Burden Of Illness ◽

Bloodstream Infections ◽

Population Based ◽

Median Length ◽

West Region ◽

Elderly Males ◽

And Gender ◽

Healthcare Associated ◽

Community Onset

SUMMARYAlthough community-onset bloodstream infection (BSI) is recognized as a major cause of morbidity and mortality, its epidemiology has not been well defined in non-selected populations. We conducted population-based surveillance in the Interior Health West region of British Columbia, Canada in order to determine the burden associated with community-onset BSI. A total of 1088 episodes were identified for an overall annual incidence of 117·8/100 000 of which 639 (58·7%) were healthcare-associated (HA) and 449 (41·3%) were community-associated (CA) BSIs for incidences of 69·2 and 48·6/100 000, respectively. The incidence of community-onset BSI varied by age and gender and elderly males were at the highest risk. Overall 964 (88·6%) episodes resulted in hospital admission for a median length of stay of 8 days; the total days of acute hospitalization associated with community-onset BSI was 13 530 days or 1465 days/100 000 population per year. The in-hospital mortality rate was 10·6% (102/964) and this was higher for HA-BSI (72/569, 12·7%) compared to CA-BSI (30/395, 7·6%, P = 0·014) episodes. Community-onset BSI, especially HA-BSI, is associated with a major burden of illness.

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Estimates and Determinants of SARS-Cov-2 Seroprevalence and Infection Fatality Ratio Using Latent Class Analysis: The Population-Based Tirschenreuth Study in the Hardest-Hit German County in Spring 2020

Viruses ◽

10.3390/v13061118 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1118

Author(s):

Ralf Wagner ◽

David Peterhoff ◽

Stephanie Beileke ◽

Felix Günther ◽

Melanie Berr ◽

...

Keyword(s):

Latent Class Analysis ◽

Latent Class ◽

Care Home ◽

Case Fatality ◽

The Elderly ◽

Population Based ◽

Class Analysis ◽

Population Based Study ◽

Targeted Testing ◽

June July

SARS-CoV-2 infection fatality ratios (IFR) remain controversially discussed with implications for political measures. The German county of Tirschenreuth suffered a severe SARS-CoV-2 outbreak in spring 2020, with particularly high case fatality ratio (CFR). To estimate seroprevalence, underreported infections, and IFR for the Tirschenreuth population aged ≥14 years in June/July 2020, we conducted a population-based study including home visits for the elderly, and analyzed 4203 participants for SARS-CoV-2 antibodies via three antibody tests. Latent class analysis yielded 8.6% standardized county-wide seroprevalence, a factor of underreported infections of 5.0, and 2.5% overall IFR. Seroprevalence was two-fold higher among medical workers and one third among current smokers with similar proportions of registered infections. While seroprevalence did not show an age-trend, the factor of underreported infections was 12.2 in the young versus 1.7 for ≥85-year-old. Age-specific IFRs were <0.5% below 60 years of age, 1.0% for age 60–69, and 13.2% for age 70+. Senior care homes accounted for 45% of COVID-19-related deaths, reflected by an IFR of 7.5% among individuals aged 70+ and an overall IFR of 1.4% when excluding senior care home residents from our computation. Our data underscore senior care home infections as key determinant of IFR additionally to age, insufficient targeted testing in the young, and the need for further investigations on behavioral or molecular causes of the fewer infections among current smokers.

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Epidemiology of Invasive Group A Streptococcal Disease in Alaska, 2001 to 2013

Journal of Clinical Microbiology ◽

10.1128/jcm.02122-15 ◽

2015 ◽

Vol 54 (1) ◽

pp. 134-141 ◽

Cited By ~ 20

Author(s):

Karen Rudolph ◽

Michael G. Bruce ◽

Dana Bruden ◽

Tammy Zulz ◽

Alisa Reasonover ◽

...

Keyword(s):

Vaccine Development ◽

Case Fatality ◽

Invasive Disease ◽

Population Based ◽

The Arctic ◽

Surveillance Program ◽

Bacterial Disease ◽

Invasive Group ◽

Laboratory Surveillance ◽

Group A

The Arctic Investigations Program (AIP) began surveillance for invasive group A streptococcal (GAS) infections in Alaska in 2000 as part of the invasive bacterial diseases population-based laboratory surveillance program. Between 2001 and 2013, there were 516 cases of GAS infection reported, for an overall annual incidence of 5.8 cases per 100,000 persons with 56 deaths (case fatality rate, 10.7%). Of the 516 confirmed cases of invasive GAS infection, 422 (82%) had isolates available for laboratory analysis. All isolates were susceptible to penicillin, cefotaxime, and levofloxacin. Resistance to tetracycline, erythromycin, and clindamycin was seen in 11% (n= 8), 5.8% (n= 20), and 1.2% (n= 4) of the isolates, respectively. A total of 51emmtypes were identified, of whichemm1 (11.1%) was the most prevalent, followed byemm82 (8.8%),emm49 (7.8%),emm12 andemm3 (6.6% each),emm89 (6.2%),emm108 (5.5%),emm28 (4.7%),emm92 (4%), andemm41 (3.8%). The five most commonemmtypes accounted for 41% of isolates. Theemmtypes in the proposed 26-valent and 30-valent vaccines accounted for 56% and 78% of all cases, respectively. GAS remains an important cause of invasive bacterial disease in Alaska. Continued surveillance of GAS infections will help improve understanding of the epidemiology of invasive disease, with an impact on disease control, notification of outbreaks, and vaccine development.

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Burden of Hospitalization Associated with Seasonal Influenza in Toronto, Canada, 2011–2016

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.737 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S315-S315

Author(s):

Taylor Kain ◽

Brenda L Coleman ◽

Kazi Hassan ◽

Karen Green ◽

Kevin Katz ◽

...

Keyword(s):

Burden Of Illness ◽

Adult Population ◽

Case Fatality ◽

Population Data ◽

Population Based ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Vaccination Programs ◽

Statistics Canada ◽

Research Grant

Abstract Background As indications for testing for influenza broaden, influenza is increasingly being diagnosed in association with hospitalization in adults. We report data on the burden of illness associated with laboratory confirmed influenza requiring hospitalization (LCI-H) in Toronto, Canada from 2010–2011 to 2015–2016. Methods TIBDN has performed population-based surveillance for LCI-H in adults (≥15years) in Toronto and Peel Region, Canada since 2005. All positive tests for influenza are reported, patients are approached for consent and data collected by chart review and patient/physician interview. Death within 30 days of hospitalization was considered associated with influenza. Population data were obtained from Statistics Canada, with data by underlying condition obtained from literature review and provincial health administrative data. Results Over 6 seasons, 5,591 LCI-H episodes were identified: 1,094 (20%) H1N1, 2,847 (51%) H3N2, 415 (7%) A(not typed), 1A(H3N2 and H1N1) and 1,235 (22%) B. The median age of patients was 71.4 years, with 69.3% of patients over 65 years of age; 3,015 (53.4%) were female, 2,618 (46.8%) had been vaccinated against influenza, and 683 (12.2%) were admitted from nursing homes. Incidence by age, influenza subtype and season is shown in Figures 1 and 2. The average annual incidence in healthy adults was 5 per 100,000, compared with 0.8 per 1,000 in adults with COPD or diabetes, 1.7 per 1,000 in adults with cardiac disease, and >2 per 1,000 in those with underlying kidney disease or immunosuppression. Overall, 12.8% of patients had a significant non-respiratory complication (eg. myocarditis, stroke, C. difficile infection). 720 (12.9%) required ICU admission, and 414 (7.4%) required mechanical ventilation. The median hospital length of stay was 9.58 days (IQR 3-11). None of 226 cases aged <30 years died; the case fatality rate increased from 1.8% in those aged 30–39 to 14.5% in those aged 90+ (Figure 3). Conclusion Despite vaccination programs, influenza is a very common cause of hospitalization and death in our adult population. While surveillance for LCI-H underestimates the overall burden of influenza, it may nonetheless help to appropriately prioritize preventive programs. Disclosures J. Powis, Merck: Grant Investigator, Research grant. GSK: Grant Investigator, Research grant. Roche: Grant Investigator, Research grant. Synthetic Biologicals: Investigator, Research grant. A. Mcgeer, Hoffman La Roche: Investigator, Research grant. GSK: Investigator, Research grant. sanofi pasteur: Investigator, Research grant.

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