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

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.

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

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.

scholarly journals 2716. Persistence of 13-Valent Pneumococcal Conjugate Vaccine (PCV13) Serotypes in Invasive Pneumococcal Disease in Adults in Southern Ontario Canada Despite Routine Pediatric Vaccination

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S955-S956
Author(s):  
Allison McGeer ◽  
Agron Plevneshi ◽  
Karen Green ◽  
Brenda Coleman ◽  
Sarah Nayani ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Medical Information ◽  
Herd Immunity ◽  
Case Fatality ◽  
Population Data ◽  
Vaccination Programs ◽  
Significant Difference ◽  
Statistics Canada ◽  
Pediatric Vaccination

Abstract Background In Ontario, Canada, PCV13 is covered for immunocompromised (IC) adults over 50y. PCV13 programs are thought not to be cost-effective in other adults because it is assumed that herd immunity from pediatric vaccination programs (PCV7 since 2005; PCV13 since 2010) will reduce PCV13 disease burden dramatically in adults. We analyzed data from the Toronto Invasive Bacterial Diseases Network (TIBDN) to ask whether PCV13-type invasive pneumococcal disease (IPD) in adults persists in our population. Methods TIBDN performs population-based surveillance for IPD in Toronto+Peel Region, Ontario (pop4.1M). All microbiology laboratories receiving specimens from residents report cases of IPD and submit isolates to a central study lab for serotyping; annual audits are conducted. Demographic, medical and vaccination information are obtained from patients, families and physicians. Population data are from Statistics Canada. Results Since 1995, 10,365 episodes of IPD have been identified; detailed medical information was available for 9,801 (95%) and serotyping for 9411 (91%). Among 8658 adult cases, 4,273 (49%) were in those aged 15–64 years, and 4,285 (51%) in those aged >645 years. The most common diagnoses were pneumonia (5,978/8,025, 74%) and bacteremia without focus (1,030, 13%); 470 (4.6%) cases had meningitis; the case fatality rate (CFR) was 21%. The incidence of disease due to STs in PCV13 in adults declined from 7.0/100,000/year 2001 to 2.9/100,000/year in 2015–2018 and was stable from 2015–2018 (Figure 1). The incidence was > 5/100,000/year in non-IC patients over 65 years, and younger patients with cancer and kidney disease (Figure 2). In IPD from 2015 to 2018, adult patients with PCV13 ST disease were younger (median age 64 years vs. 67 years, P = .03) than other patients; there was no significant difference in the proportion with at least one underlying chronic condition (253, 69% PCV13ST, vs. 541,74% other ST, P = 0.08), or in CFR (59, 16% PCV13 vs. 145, 20% other, P = 0.13). The ST distribution of cases due to PCV13 STs is shown in Figure 3. Conclusion A significant burden of IPD due to PCV13 serotypes persists in adults in our population despite 8 years of routine pediatric PCV13 vaccination. This burden needs to be considered in assessing the value and cost-effectiveness of PCV programs for adults. Disclosures All authors: No reported disclosures.

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

2019 ◽  
Vol 19 (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.

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

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.

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

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.

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

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.

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

2006 ◽  
Vol 135 (6) ◽  
pp. 1037-1042 ◽  
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.

scholarly journals COVID-19 Mortality and Case-Fatality Rates in Sergipe State, Northeast Brazil, From April to June 2020

2021 ◽  
Vol 9 ◽  
Author(s):  
Paulo R. Martins-Filho ◽  
Adriano A. S. Araújo ◽  
Marco A. O. Góes ◽  
Mércia S. F. de Souza ◽  
Lucindo J. Quintans-Júnior ◽  
...  
Keyword(s):  
Time Lag ◽  
Case Series ◽  
Case Fatality ◽  
Population Data ◽  
Population Based ◽  
Population Characteristics ◽  
Northeast Brazil ◽  
Middle Income ◽  
Middle Income Countries ◽  
Case Series Study

Information on how coronavirus disease 2019 (COVID-19) mortality is related to population characteristics in low- and middle-income countries is still limited. We described the deaths from COVID-19 in Sergipe state, Northeast Brazil, from April 2 to June 27, 2020. For this purpose, we conducted a study composed of (i) a case series study of all deaths due to COVID-19 and (ii) a population-based study to verify the behavior of the mortality and case-fatality rates (CFR) related to COVID-19. Data from 605 deaths due to COVID-19 were used to describe the characteristics of individuals with the disease, as well as the differences in gender, age, and comorbidities. Additionally, population data were extracted to estimate the mortality and CFR by population stratum. We also performed an adjusted CFR analysis including a time lag of 14 days between the onset of symptoms and reporting deaths. Of the 605 patients included in this study, 321 (53.1%) were males and the median age was 67.0 years. Most patients (n = 447, 73.9%) who died from COVID-19 had at least one pre-existing clinical condition. The mortality rate was 29.3 deaths per 100,000 inhabitants and the crude CRF was 2.6% (95% CI 2.4–2.8). CFR was higher in males (3.1%, 95% CI 2.8–3.4; p &lt; 0.001) and people aged ≥60 years (14.2%, 95% CI 13.0–15.6; p = 0.042). About 25% of patients died during the first 24-h post-hospital admission. The adjusted CFR for a 14-day time lag was ~2-fold higher than the crude CFR over the study period.

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