Risk Factors for the Development of Bacteremia in Previously Healthy Children with Non-typhoidal Salmonella Gastroenteritis

Abstract Background Non-typhoidal Salmonella (NTS) causes approximately 1.2 million illnesses per year in the United States. There are very few pediatric studies which has investigated the risk factors for NTS bacteremia in healthy children with NTS gastroenteritis (NTS-AGE). Methods This was a retrospective study of children admitted to Texas Children’s Hospital, Houston, TX, with NTS-AGE from 2007–2016. Exclusion criteria included: patients aged ≤3 m or > 18 years, immunodeficiencies, hemoglobinopathies, extraintestinal manifestations or those in whom blood cultures were not obtained. Demographics, clinical and laboratory data were collected from electronic medical records. Patients with NTS bacteremia (NTS-B) were compared with patients who were non-bacteremic (NTS-NB). Results Of 350 patients reviewed, 83 patients met inclusion criteria: 53 with NTS-B and 30 NTS-NB. The median age of diagnosis was 1.58 years (range 3.5 months-18 years). Thirty-nine patients (47.0%) were female and 44 (53.0%) were male. Majority of patients were non-Hispanic White (n = 70; 84.3%). The most common serotype was Salmonella Group C (n = 41(49.4%). There was no difference in risk factors between NTS-B vs. NTS-NB in terms of age, duration of diarrhea prior to admission, travel or pet exposure, prior antibiotic exposure or white blood cell count at presentation. Duration of fever prior to admission was statistically significant with median duration for NTS-B being 6.11 days compared with NTS-NB at 1.97 days (P =  0.0000006). There was an increased trend for bacteremia in males and Salmonella Group C bacteremia (P = 0.07 and P = 0.08 respectively). Conclusion To our knowledge this is first pediatric study in the United States to evaluate risk factors for NTS bacteremia in healthy children with NTS-AGE. Duration of fever prior to admission was associated with increased risk of NTS-B along with increased trend with males and infection with Group C Salmonella. These risk factors should prompt clinicians to monitor patients with NTS-AGE closely and help in deciding whether antimicrobials are warranted or not. Disclosures All authors: No reported disclosures.

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1342. TOSCANA: The Observational Seroepidemiologic Study of COVID-19 at the United States Naval Academy

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.1534 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S758-S759

Author(s):

Eugene Millar ◽

Eric Laing ◽

Adam Saperstein ◽

Jitu Modi ◽

Christopher Heaney ◽

...

Keyword(s):

United States ◽

Risk Factors ◽

Blood Sample ◽

Saliva Sample ◽

The United States ◽

Pathogen Transmission ◽

Naval Academy ◽

United States Naval Academy ◽

Increased Risk ◽

Seroepidemiologic Study

Abstract Background University students, including those at military service academies, are at increased risk of acute respiratory infection (ARI), including SAR-CoV-2, due to crowded living conditions, frequent social interaction and other factors that facilitate pathogen transmission. Unlike many universities, the United States Naval Academy (USNA) continued in-person instruction in Fall 2020 in the midst of the COVID-19 pandemic. The Observational Seroepidemiologic Study of COVID-19 at the United States Naval Academy (TOSCANA,) a longitudinal cohort characterizes the burden and risk factors of SARS-CoV-2 in USNA midshipmen. Methods Midshipmen were enrolled August- October 2020. Participants were queried about their ARI risk factors, COVID-19 history, and recent receipt of medical care for any ARI at enrollment, in December 2020 and again in May 2021. Subjects were also asked to provide blood and saliva samples to assess their SARS-CoV-2 serostatus at the same three timepoints. A saliva sample was collected by a subset of subjects in February 2021. Presence of anti-SARS-CoV-2 serum IgG in dried blood spots and saliva was measured by multiplex magnetic microparticle-based immunoassays. Results 181 midshipmen consented to the study and completed the baseline survey (Table 1). 17 (17.5%) of the 97 subjects who submitted baseline blood sample were SARS-CoV-2 seropositive. Only 4 (24%) positive individuals reported having been tested for or diagnosed with COVID-19 prior to arrival at USNA. 121 participants completed the midyear survey, of whom 61 (50%) submitted a blood sample. 16 (26%) of the midyear specimens were SARS-CoV-2 positive. Of these, 3 were new infections. 73 subjects completed the May survey, and 63 (100%) of the submitted blood samples were positive. 83 subjects provided baseline saliva samples, and ~55 submitted saliva at each successive time point. 1 (5%) was positive at enrollment, 9 (17%) were positive at midyear and 47 (96%) were positive in May. Table 1. Key characteristics of TOSCANA participants Conclusion SAR-CoV-2 prevalence in a sample of USNA midshipmen was < 20% at enrollment. A small proportion of subjects seroconverted between the September and December visits. SARS-CoV-2 positivity rose in May, following a COVID-19 outbreak in February and COVID-19 vaccination efforts in March at USNA. Disclosures Jitu Modi, MD, GSK (Speaker’s Bureau)

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Motor Vehicle Fatalities during Memorial Day Weekends, 1981-2016

10.21203/rs.2.16680/v3 ◽

2019 ◽

Author(s):

Yuni Tang ◽

Kendra L Ratnapradipa ◽

Henry Xiang ◽

Motao Zhu

Keyword(s):

United States ◽

Risk Factors ◽

Motor Vehicle ◽

The United States ◽

Motor Vehicle Crashes ◽

Traffic Fatalities ◽

Injury Death ◽

Rural And Urban ◽

Increased Risk ◽

Potential Risk Factors

Abstract Objective: Motor vehicle crashes are a leading cause of injury death in the United States, and Memorial Day weekend is one of six holiday periods with an increased number of motor vehicle fatalities in the United States. However, few motor vehicle fatality comparisons were made between Memorial Day weekend and non-holiday periods. Our aims were to determine which day(s) during the holiday had highest motor vehicle fatality risk compared to non-holiday travel and to identify potential risk factors. Results: Of 43,457 traffic fatalities studied, 15,292 (35%) occurred during the holiday, with Saturday being deadliest but Monday having highest odds. Both sexes, all years, age <65, drivers and passengers, rural and urban, and all regions in the United States were at increased risk during the holiday versus non-holiday periods.

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COVID-19 and Immigrant Essential Workers: Bhutanese and Burmese Refugees in the United States

Public Health Reports ◽

10.1177/0033354920971720 ◽

2020 ◽

Vol 136 (1) ◽

pp. 117-123

Author(s):

Mengxi Zhang ◽

Ashok Gurung ◽

Philip Anglewicz ◽

Katherine Yun

Keyword(s):

United States ◽

Risk Factors ◽

Online Survey ◽

Sampling Strategy ◽

The United States ◽

Community Leaders ◽

Snowball Sampling ◽

Asian Immigrant ◽

Related Risk ◽

Increased Risk

Objectives Immigrants are believed to be at high risk of infection with severe acute respiratory syndrome coronavirus 2, the virus that causes coronavirus disease 2019 (COVID-19). A leading suspected risk factor is their role in the essential workforce. We aimed to describe COVID-19–related risk factors among Bhutanese and Burmese refugees in the United States. Methods We administered an anonymous online survey in May 2020 among community leaders of Bhutanese and Burmese refugees. Using a snowball sampling strategy, we invited community leaders to complete the survey and share the link with others who met inclusion criteria (English proficient, aged ≥18, currently living in the United States). We compared respondents with and without recent COVID-19 and identified risk factors for infection. Results Of 218 refugees in 23 states who completed the survey from May 15 through June 1, 2020, fifteen (6.9%) reported infection with COVID-19. Being an essential worker during the pandemic (odds ratio [OR] = 5.25; 95% CI, 1.21-22.78), having an infected family member (OR = 26.92; 95% CI, 5.19-139.75), and being female (OR = 5.63; 95% CI, 1.14-27.82) were risk factors for infection. Among 33 infected family members, 23 (69.7%) were essential workers. Conclusion Although we had a small snowball sample, we found that working in essential industries was associated with an increased risk of COVID-19 infection among Bhutanese and Burmese refugees. We call for larger studies that include Asian immigrant subgroups, as well as immediate attention to protecting immigrant essential workers during the COVID-19 pandemic.

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Venous Thromboembolic Events after Total Knee Arthroplasty: Which Patients Are at a High Risk?

The Journal of Knee Surgery ◽

10.1055/s-0039-1688962 ◽

2019 ◽

Vol 33 (10) ◽

pp. 947-957 ◽

Cited By ~ 2

Author(s):

Wen-Li Dai ◽

Ze-Ming Lin ◽

Zhan-Jun Shi ◽

Jian Wang

Keyword(s):

United States ◽

Risk Factors ◽

Total Knee Arthroplasty ◽

Hospital Stay ◽

Knee Arthroplasty ◽

The United States ◽

Inhospital Mortality ◽

Increased Risk ◽

Venous Thromboembolic Events ◽

Total Knee

AbstractVenous thromboembolism (VTE; deep venous thrombosis and pulmonary embolism) is a known complication following primary total knee arthroplasty (TKA). The aim of this study was to investigate the trends of the incidence of VTE after primary TKA and identify associated risk factors for the occurrence of VTEs in a large cohort of TKA patients. We performed a retrospective study in which the Nationwide Inpatient Sample (NIS) database was used to identify all patients who underwent primary TKA over a period of 13 consecutive years (between 2002 and 2014) in the United States. The occurrence of a symptomatic VTE was identified with the use of ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) diagnosis codes. A total of 1,460,901 primary TKA procedures were identified in the NIS from 2002 to 2014, and 12,944 of these patients were recorded as having 13,855 VTEs, consisting of 7,609 deep venous thromboses (0.52%) and 6,246 pulmonary emboli (0.43%). The overall VTE incidence in patients undergoing TKA in the United States from 2002 to 2014 was 0.89%. Patient-related risk factors for VTEs include an older age (odds ratio [OR]: 1.44; 95% confidence interval [CI]: 1.31–1.59), black race (OR: 1.34; 95% CI: 1.25–1.44), and Medicare insurance (OR: 1.18; 95% CI: 1.13–1.22). Most of the comorbidities were associated with an increased risk of VTE following TKA. Particularly, cardiac arrhythmias, coagulopathy, fluid and electrolyte disorders, pulmonary circulation disorders, and weight loss increased the risk of VTE by more than twofold. After adjusting for confounders, VTE was associated with a longer hospital stay (2.81 ± 0.02 day), increased costs (US$14,212.16 ± US$255.64), and higher mortality rate (OR: 13.04; 95% CI: 11.08–15.35). This nationally representative study of inpatients in the United States identified several independent risk factors for VTE perioperatively in TKA patients and provided evidence that VTE patients after TKA are likely to have worse results than non-VTE patients with regard to the length of hospital stay, hospital costs, and inhospital mortality. This is a level III, prognostic study.

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Characteristics and risk factors of rheumatoid arthritis in the United States: an NHANES analysis

PeerJ ◽

10.7717/peerj.4035 ◽

2017 ◽

Vol 5 ◽

pp. e4035 ◽

Cited By ~ 8

Author(s):

Bei Xu ◽

Jin Lin

Keyword(s):

Rheumatoid Arthritis ◽

United States ◽

Odds Ratio ◽

Mexican American ◽

Multivariable Analysis ◽

The United States ◽

Exclusion Criteria ◽

Factors Associated ◽

Health And Nutrition ◽

Hispanic White

Background We examined the United States National Health and Nutrition Examination Survey (NHANES) database to determine factors associated with rheumatoid arthritis (RA) in adults 20 to 55 years of age. Methods NHANES data collected between 2007 and 2014, excluding the 2011–2012 period, were used. Subjects were divided into those with and without RA. Demographic, clinical, and lifestyle factors were compared between the groups. Results After applying inclusion/exclusion criteria, 8,789 persons were included in the study (8,483 without RA, 306 with RA). Multivariable analysis indicated that advanced age (odds ratio [OR] = 1.09, 95% CI [1.07–1.11], P < 0.001), regular smoking (OR = 2.19, 95% CI [1.49–3.21], P < 0.001), diabetes (OR = 2.00, 95% CI [1.35–2.95], P = 0.001), obesity (reference, normal or underweight; OR = 3.31, 95% CI [2.05–5.36], P < 0.001), and osteoporosis (OR = 3.68, 95% CI [1.64–8.22], P = 0.002) were positively associated with RA. Covered by health insurance (OR = 1.81, 95% CI [1.12–2.93], P = 0.016) and living in poverty (OR = 2.96, 95% CI [1.88–4.65], P < 0.001) were also associated with having RA. Mexican American, Hispanic white or other Hispanic ethnicity (reference, non-Hispanic white; OR = 0.54, 95% CI [0.31–0.96], P = 0.036), appropriate sleep duration (about 6–11 h, OR = 0.46, 95% CI [0.32–0.65], P < 0.001), and insufficient vitamin A intake (reference, recommended; OR = 0.70, 95% CI [0.50–0.98], P = 0.036) were negatively associated with RA. Discussion Some factors associated with RA are potentially modifiable.

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SARS-CoV-2 Vaccine Acceptability in Patients on Hemodialysis: A Nationwide Survey

Journal of the American Society of Nephrology ◽

10.1681/asn.2021010104 ◽

2021 ◽

pp. ASN.2021010104

Author(s):

Pablo Garcia ◽

Maria E. Montez-Rath ◽

Heather Moore ◽

Johnie Flotte ◽

Chris Fults ◽

...

Keyword(s):

United States ◽

Native American ◽

Side Effects ◽

The United States ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Vaccine Acceptability ◽

Increased Risk ◽

Hispanic White ◽

White Patients

BackgroundPatients on dialysis are at increased risk for COVID-19–related complications. However, a substantial fraction of patients on dialysis belong to groups more likely to be hesitant about vaccination.MethodsWith the goal of identifying strategies to increase COVID-19 vaccine uptake among patients on hemodialysis, we conducted a nationwide vaccine acceptability survey, partnering with a dialysis network to distribute an anonymized English and Spanish language online survey in 150 randomly selected facilities in the United States. We used logistic regression to evaluate characteristics of vaccine-hesitant persons.ResultsA total of 1515 (14% of eligible) patients responded; 20% of all responders, 29% of patients aged 18–44 years, and 29% of Black responders reported being hesitant to seek the COVID-19 vaccine, even if the vaccine was considered safe for the general population. Odds of vaccine hesitancy were higher among patients aged 18–44 years versus those 45–64 years (odds ratio [OR], 1.5; 95% confidence interval [95% CI], 1.0 to 2.3), Black patients versus non-Hispanic White patients (OR, 1.9; 95% CI, 1.3 to 2.7), Native Americans or Pacific Islanders versus non-Hispanic White patients (OR, 2.0; 95% CI, 1.1 to 3.7), and women versus men (OR, 1.6; 95% CI, 1.2 to 2.0). About half (53%) of patients who were vaccine hesitant expressed concerns about side effects. Responders’ main information sources about COVID-19 vaccines were television news and dialysis staff (68% and 38%, respectively).ConclusionsA substantial proportion of patients receiving in-center hemodialysis in the United States are hesitant about seeking COVID-19 vaccination. Facilitating uptake requires outreach to younger patients, women, and Black, Native American, or Pacific Islander patients, and addressing concerns about side effects.

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Motor Vehicle Fatalities during Memorial Day Weekends, 1981-2016

10.21203/rs.2.16680/v1 ◽

2019 ◽

Author(s):

Yuni Tang ◽

Kendra L Ratnapradipa ◽

Henry Xiang ◽

Motao Zhu

Keyword(s):

United States ◽

Risk Factors ◽

Potential Risk ◽

Motor Vehicle ◽

The United States ◽

Traffic Fatalities ◽

Fatality Risk ◽

Rural And Urban ◽

Increased Risk ◽

Potential Risk Factors

Abstract Objective: Our aims were to determine which day(s) during the holiday had highest motor vehicle fatality risk compared to non-holiday travel and to identify potential risk factors. Results: Of 43,457 traffic fatalities studied, 15,292 (35%) occurred during the holiday, with Saturday being deadliest but Monday having highest odds. Both sexes, all years, age <65, drivers and passengers, rural and urban, and all regions in the United States were at increased risk during the holiday versus non-holiday periods.

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Motor Vehicle Fatalities during Memorial Day Weekends, 1981-2016

10.21203/rs.2.16680/v2 ◽

2019 ◽

Author(s):

Yuni Tang ◽

Kendra L Ratnapradipa ◽

Henry Xiang ◽

Motao Zhu

Keyword(s):

United States ◽

Risk Factors ◽

Motor Vehicle ◽

The United States ◽

Motor Vehicle Crashes ◽

Traffic Fatalities ◽

Injury Death ◽

Rural And Urban ◽

Increased Risk ◽

Potential Risk Factors

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Prostate cancer

Modern Oncology ◽

10.26442/18151434.2021.2.200959 ◽

2021 ◽

Vol 23 (2) ◽

pp. 211-247

Author(s):

Andrei D. Kaprin ◽

Boris Ia. Alekseev ◽

Vsevolod B. Matveev ◽

Dmitrii Iu. Pushkar’ ◽

Aleksandr V. Govorov ◽

...

Keyword(s):

Prostate Cancer ◽

United States ◽

Risk Factors ◽

African Americans ◽

Prostate Gland ◽

Malignant Neoplasm ◽

The United States ◽

White Americans ◽

Animal Fats ◽

Increased Risk

Prostate cancer (RPP) is a malignant neoplasm that arises from the epithelium of the prostate gland gland (PJ). рак предстательной железы; клинические рекомендацииThethiology and pathogenesis of this disease remain poorly studied. Many studies are aimed at studying diet, food, hormonal impact, as well as infections in the etiology of the RLPG. The prevalence of RPL depends on ethnic and geographical features. The highest incidence of African Americans living in the United States (60% higher than that of white Americans), the least high - in the Chinese living in China [1]. In addition to racial features, the risk factors of the RPG are considering the genetic predisposition, the age of men and nutritional features. The probability of developing a PJ tumor in a man who has one of the closest relatives of the first degree of kinship (father or brother) sick of the RLPG, is 1.8 times higher than in the population. If two relatives were sick or more (father and brother or both brothers), the risk of RPG increases in 5.51 and 7.71 times, respectively [2, 3]. African Americans have an increased risk of identifying RPG, as well as a greater probability of detecting aggressive RPG [4]. Also, the risk of RLPG is rising in men who use a large amount of animal fats [5].

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