Illness prevalence and symptoms in youth floorball players: a one-season prospective cohort study involving 471 players

ObjectiveTo describe weekly illness prevalence and illness symptoms by sex in youth floorball players during one season.DesignProspective cohort study.SettingPlayers who were registered to play community level floorball during the 2017–2018 season (26 weeks) in two provinces in southern Sweden.Participants471 youth players aged 12–17 years. Mean (SD) age for 329 male players 13.3 (1.0) years and 142 female players 13.7 (1.5) years.Primary and secondary outcome measuresWeekly self-reported illness prevalence and illness symptoms according to the 2020 International Olympic Committee’s consensus recommendations.Results61% of youth floorball players reported at least one illness week during the season, with an average weekly illness prevalence of 12% (95% CI 10.8% to 12.3%). The prevalence was slightly higher among females (13%, 95% CI 11.6% to 14.3%) than males (11%, 95% CI 9.9% to 11.7%), prevalence rate ratio 1.20 (95% CI 1.05 to 1.37, p=0.009). In total, 49% (53% male, 43% female) of illness reports indicated that the player could not participate in floorball (time loss), with a mean (SD) absence of 2.0 (1.7) days per illness week. Fever (30%), sore throat (16%) and cough (14%) were the most common symptoms. Female players more often reported difficulty in breathing/tight airways and fainting, and male players more often reported coughing, feeling tired/feverish and headache. Illness prevalence was highest in the peak winter months (late January/February) reaching 15%–18% during this period.ConclusionsOur novel findings of the illness prevalence and symptoms in youth floorball may help direct prevention strategies. Athletes, coaches, parents and support personnel need to be educated about risk mitigation strategies.Trial registration numberNCT03309904.

803. The Impact of Bundled Interventions to Decrease Transmission of Drug-Resistant Pseudomonas aeruginosa from Wastewater Drain Sites on a Hematologic Malignancy/Hematopoietic Stem Cell Transplant Unit

Background Wastewater drain (WWD) sites are an important reservoir for amplification, propagation and transmission of multidrug resistant organisms. We observed an increase in the incidence of carbapenem and fluoroquinolone non-susceptible (CP-NS and FQ-NS) P. aeruginosa bloodstream infections (BSI) among patients on our hematologic malignancies (HM) and hematopoietic cell transplant (HCT) unit. The incidence of CP-NS/FQ-NS P. aeruginosa BSI from 2012 through May 2021 is represented in Figure 1. We sought to determine the impact of low-cost, low-barrier interventions targeting WWD sites on the prevalence of patient and environmental P. aeruginosa colonization and incidence of BSI. Figure 1. Incidence of P. aeruginosa BSI, 2012 through May 2021 Methods Behavioral and structural interventions to limit acquisition from WWD sites were informed by an environmental analysis and rolled out in staged fashion beginning in September 2019. Pre- and post-intervention colonization surveys were performed on the unit to assess for patient and WWD site P. aeruginosa colonization. Whole genome sequencing (WGS) was performed on select isolates. A sensitivity analysis performed accounted for the unconfirmed patient isolates. BSI data was collected retrospectively. Results Characteristics of the pre- and post-intervention groups are presented in Table 1. Five of 27 (18.5%) and 1 of 26 (3.8%) patients in the pre- and post-intervention point prevalence survey, respectively, were confirmed to be colonized with P. aeruginosa (Figure 2), corresponding to a prevalence rate ratio of 0.21 (0.03,1.66). If the two indeterminate samples in the pre-intervention period were positive, the prevalence rate ratio would instead be 0.15 (0.02,1.12). The most frequent P. aeruginosa strains identified by WGS from the patients and environment were 111, 308 and 446. At least 87% of rooms were colonized with P. aeruginosa from at least one WWD site, from pre- and post-intervention periods (Table 2). Table 1. Demographic and clinical characteristics of patients in each epoch. Results are given as percent (frequency) unless otherwise noted. Chi square test was used unless otherwise noted. Figure 2. Proportion of patients colonized with P. aeruginosa Positive: Colonized with P. aeruginosa, confirmed by WGS; Unknown: Phenotype of isolate suggestive of P. aeruginosa, WGS not performed; Negative: No growth on selective agar or non-P aeruginosa identification on WGS Table 2. WWD site colonization, by phenotypic and WGS determination. Fisher’s exact test was used unless otherwise noted. Conclusion P. aeruginosa WWD colonization on our HM/HCT unit may predispose patients to colonization and BSI. The prevalence of patient colonization decreased following implementation of the interventions, despite persistent environmental colonization. We will follow the incidence of P. aeruginosa BSI to determine the long-term impact of these interventions. Disclosures All Authors: No reported disclosures

Supplementation with Small-Quantity Lipid-Based Nutrient Supplements Does Not Increase Child Morbidity in a Semiurban Setting in Ghana: A Secondary Outcome Noninferiority Analysis of the International Lipid-Based Nutrient Supplements (iLiNS)–DYAD Randomized Controlled Trial

ABSTRACT Background Adequate knowledge about the safety of consumption of small-quantity lipid-based nutrient supplements (SQ-LNSs) is needed. Objective We aimed to test the hypothesis that SQ-LNS consumption is noninferior to control with respect to child morbidity. Methods Women (n = 1320) ≤20 wk pregnant were assigned to iron and folic acid until delivery with no supplementation for offspring; or multiple micronutrient supplements until 6 mo postpartum with no supplementation for offspring; or SQ-LNSs until 6 mo postpartum, and SQ-LNSs for offspring (6 mg Fe/d) from 6 to 18 mo of age [the lipid-based nutrient supplement (LNS) group]. We assessed noninferiority (margin ≤20%) between any 2 groups during 0–6 mo of age, and between the non-LNS and LNS groups during 6–18 mo of age for caregiver-reported acute respiratory infection, diarrhea, gastroenteritis, fever/suspected malaria, poor appetite, and “other illnesses.” Results During 0–6 mo of age, 1197 infants contributed 190,503 infant-days. For all morbidity combined, overall mean incidence (per 100 infant-days) was 3.3 episodes, overall mean prevalence (percentage of infant-days) was 19.3%, and the 95% CIs of the incidence rate ratio (IRR) and longitudinal prevalence rate ratio (LPRR) between any 2 groups were ≤1.20. During 6–18 mo, there were 240,097 infant-days for the non-LNS group and 118,698 for the LNS group. For all morbidity combined, group mean incidences were 4.3 and 4.3, respectively (IRR: 1.0; 95% CI: 1.0, 1.1), and mean prevalences were 28.2% and 29.3%, respectively (LPRR: 1.0; 95% CI: 1.0, 1.1). Noninferiority was inconclusive for diarrhea, fever/suspected malaria, and poor appetite. Conclusions SQ-LNS consumption does not increase reported overall child morbidity in this population compared with the 2 other treatments. This trial was registered at clinicaltrials.gov as NCT00970866.

Determinants of international variation in the prevalence of disabling wrist and hand pain

Background Previous research has indicated that wide international variation in the prevalence of disabling low back pain among working populations is largely driven by factors predisposing to musculoskeletal pain more generally. This paper explores whether the same applies to disabling wrist/hand pain (WHP). Methods Using data from the Cultural and Psychosocial Influences on Disability (CUPID) study, we focused on workers from 45 occupational groups (office workers, nurses and other workers) in 18 countries. Among 11,740 participants who completed a baseline questionnaire about musculoskeletal pain and potential risk factors, 9082 (77%) answered a further questionnaire after a mean interval of 14 months, including 1373 (15%) who reported disabling WHP in the month before follow-up. Poisson regression was used to assess associations of this outcome with baseline risk factors, including the number of anatomical sites other than wrist/hand that had been painful in the 12 months before baseline (taken as an index of general propensity to pain). Results After allowance for other risk factors, the strongest associations were with general pain propensity (prevalence rate ratio for an index ≥6 vs. 0: 3.6, 95% confidence interval 2.9–4.4), and risk rose progressively as the index increased. The population attributable fraction for a pain propensity index > 0 was 49.4%. The prevalence of disabling WHP by occupational group ranged from 0.3 to 36.2%, and correlated strongly with mean pain propensity index (correlation coefficient 0.86). Conclusion Strategies to prevent disability from WHP among working populations should explore ways of reducing general propensity to pain, as well as improving the ergonomics of occupational tasks.

3445 Cannabis use and risk of H. pylori infection; analysis of inpatients and residents of the US.

OBJECTIVES/SPECIFIC AIMS: Cannabinoids suppress gastric acid secretion, ameliorate gastric inflammation, and promote gastric ulcer healing, all of which are triggered by H pylori (Hp). Our aim was to determine the relationship between cannabis use and: 1) H pylori infection (HPI) among community residents 2) clinical peptic ulcer disease (PUD) and its complications among hospitalized patients. METHODS/STUDY POPULATION: We performed case-control studies with records from the NHANES III (n=4,556) and HCUP-NIS 2014 (n=4,555,029), and respectively identified subjects with seropositivity for H pylori and clinical PUD, and their cannabis usage status. In the NHANES III, we estimated the adjusted prevalence rate ratio (aPRR) of having HPI with cannabis use, using generalized estimating equations. In the NIS, we propensity-matched cannabis users to non-users in ratio 1:1 (68,073:68,073) and measured the aPRR of having PUD and its complications (SAS 9.4). RESULTS/ANTICIPATED RESULTS: In NHANES III, associated with decreased HPI seropositivity were cannabis ever-users (aPRR: 0.79[0.66-0.95]), greater than 10 times lifetime usage (0.65[0.5-0.84]) and recent 31-day usage (0.67[0.48-0.98]), compared to never usage. In the HCUP-NIS, cannabis users had decreased risk for total PUD (aPRR: 0.74[0.61-0.89]), duodenal PUD (0.48[0.35-0.60]) and PUD complications including hemorrhage (0.58[0.37-0.90]), perforation (0.66[0.51-0.87]), but not obstruction (1.75[0.51-5.98]). DISCUSSION/SIGNIFICANCE OF IMPACT: Cannabis usage is related to a reduced likelihood of having HPI in the community and also mitigate against having complicated presentations to the hospital. More translational studies are needed to illuminate the details of this relationship, given the high worldwide prevalence of both cannabis use and HPI.

High prevalence of anti-hepatitis E virus antibodies among blood donors in central Italy, February to March 2014

Prevalence of anti-hepatitis E virus (HEV) antibodies is highly variable in developed countries, which seems partly due to differences in assay sensitivity. Using validated sensitive assays, we tested 313 blood donors attending a hospital transfusion unit in central Italy in January and February 2014 for anti-HEV IgG and IgM and HEV RNA. Data on HEV exposure were collected from all donors. Overall anti-HEV IgG prevalence was 49% (153/313). Eating raw dried pig-liver sausage was the only independent predictor of HEV infection (adjusted prevalence rate ratio = 2.14; 95% confidence interval: 1.23–3.74). Three donors were positive for either anti-HEV IgM (n = 2; 0.6%) or HEV RNA (n = 2; 0.6%); they were completely asymptomatic, without alanine aminotransferase (ALT) abnormalities. Of the two HEV RNA-positive donors (both harbouring genotype 3), one was anti-HEV IgG- and IgM-positive, the other was anti-HEV IgG- and IgM-negative. The third donor was positive for anti-HEV IgG and IgM but HEV RNA-negative. HEV infection is therefore hyperendemic among blood donors (80% men 18–64 years-old) from central Italy and associated with local dietary habits. Nearly 1% of donors have acute or recent infection, implying potential transmission to blood recipients. Neither ALT nor anti-HEV IgM testing seems useful to prevent transfusion-transmitted HEV infection.

Epidemiology of Surgical Site Infection in a Community Hospital Network

OBJECTIVETo describe the epidemiology of complex surgical site infection (SSI) following commonly performed surgical procedures in community hospitals and to characterize trends of SSI prevalence rates over time for MRSA and other common pathogensMETHODSWe prospectively collected SSI data at 29 community hospitals in the southeastern United States from 2008 through 2012. We determined the overall prevalence rates of SSI for commonly performed procedures during this 5-year study period. For each year of the study, we then calculated prevalence rates of SSI stratified by causative organism. We created log-binomial regression models to analyze trends of SSI prevalence over time for all pathogens combined and specifically for MRSA.RESULTSA total of 3,988 complex SSIs occurred following 532,694 procedures (prevalence rate, 0.7 infections per 100 procedures). SSIs occurred most frequently after small bowel surgery, peripheral vascular bypass surgery, and colon surgery. Staphylococcus aureus was the most common pathogen. The prevalence rate of SSI decreased from 0.76 infections per 100 procedures in 2008 to 0.69 infections per 100 procedures in 2012 (prevalence rate ratio [PRR], 0.90; 95% confidence interval [CI], 0.82–1.00). A more substantial decrease in MRSA SSI (PRR, 0.69; 95% CI, 0.54–0.89) was largely responsible for this overall trend.CONCLUSIONSThe prevalence of MRSA SSI decreased from 2008 to 2012 in our network of community hospitals. This decrease in MRSA SSI prevalence led to an overall decrease in SSI prevalence over the study period.Infect Control Hosp Epidemiol 2016;37:519–526