Clinical burden of invasive Escherichia coli disease among older adult patients treated in hospitals in the United States
Abstract Background Invasive extraintestinal pathogenic Escherichia coli disease (IED) can lead to severe outcomes, particularly among older adults. However, the clinical burden of IED in the U.S. has not been well characterized. Methods IED encounters among patients ≥ 60 years old were identified u...
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-023-08479-3 |
| _version_ | 1797453737623552000 |
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| author | Luis Hernandez-Pastor Jeroen Geurtsen Bryan Baugh Antoine C. El Khoury Nnanya Kalu Marjolaine Gauthier-Loiselle Rebecca Bungay Martin Cloutier Michal Sarnecki Elie Saade |
| author_facet | Luis Hernandez-Pastor Jeroen Geurtsen Bryan Baugh Antoine C. El Khoury Nnanya Kalu Marjolaine Gauthier-Loiselle Rebecca Bungay Martin Cloutier Michal Sarnecki Elie Saade |
| author_sort | Luis Hernandez-Pastor |
| collection | DOAJ |
| description | Abstract Background Invasive extraintestinal pathogenic Escherichia coli disease (IED) can lead to severe outcomes, particularly among older adults. However, the clinical burden of IED in the U.S. has not been well characterized. Methods IED encounters among patients ≥ 60 years old were identified using the PINC AI™ Healthcare Database (10/01/2015–03/31/2020) by either a positive E. coli culture in blood or another normally sterile body site and ≥ 1 sign of systemic inflammatory response syndrome or signs of sepsis, or a positive E. coli culture in urine with urinary tract infection and signs of sepsis. Medical resource utilization, clinical outcomes, and E. coli isolate characteristics were descriptively reported during the first IED encounter and during the following year (observation period). Results Overall, 19,773 patients with IED were included (mean age: 76.8 years; 67.4% female; 78.5% with signs of sepsis). Most encounters involved community-onset IED (94.3%) and required hospitalization (96.5%; mean duration: 6.9 days), with 32.4% of patients being admitted to the intensive care unit (mean duration: 3.7 days). Most E. coli isolates were resistant to ≥ 1 antibiotic category (61.7%) and 34.4% were resistant to ≥ 3 antibiotic categories. Following their first IED encounter, 34.8% of patients were transferred to a skilled nursing/intermediate care facility, whereas 6.8% had died. During the observation period, 36.8% of patients were rehospitalized, 2.4% had IED recurrence, and in-hospital death increased to 10.9%. Conclusions IED is associated with substantial clinical burden at first encounter with considerable long-term consequences. Findings demonstrate the need for increased IED awareness and highlight potential benefits of prevention. |
| first_indexed | 2024-03-09T15:27:10Z |
| format | Article |
| id | doaj.art-5a6d3d9236844c2a91cf55a31f39f532 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-03-09T15:27:10Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-5a6d3d9236844c2a91cf55a31f39f5322023-11-26T12:27:31ZengBMCBMC Infectious Diseases1471-23342023-08-0123111210.1186/s12879-023-08479-3Clinical burden of invasive Escherichia coli disease among older adult patients treated in hospitals in the United StatesLuis Hernandez-Pastor0Jeroen Geurtsen1Bryan Baugh2Antoine C. El Khoury3Nnanya Kalu4Marjolaine Gauthier-Loiselle5Rebecca Bungay6Martin Cloutier7Michal Sarnecki8Elie Saade9Global Market Access, Vaccines Janssen Pharmaceutica NVMolecular Bacteriology & Bacterial Epidemiology, Janssen Vaccines & Prevention BVGlobal Medical Affairs, Janssen Research & Development, LLCGlobal Market Access, Janssen Global Services, LLCUS Vaccines Medical Affairs, Janssen Scientific Affairs, LLCHealth Economics and Outcomes Research, Analysis Group, IncHealth Economics and Outcomes Research, Analysis Group, IncHealth Economics and Outcomes Research, Analysis Group, IncClinical DevelopmentDepartment of Medicine, Case Western Reserve UniversityAbstract Background Invasive extraintestinal pathogenic Escherichia coli disease (IED) can lead to severe outcomes, particularly among older adults. However, the clinical burden of IED in the U.S. has not been well characterized. Methods IED encounters among patients ≥ 60 years old were identified using the PINC AI™ Healthcare Database (10/01/2015–03/31/2020) by either a positive E. coli culture in blood or another normally sterile body site and ≥ 1 sign of systemic inflammatory response syndrome or signs of sepsis, or a positive E. coli culture in urine with urinary tract infection and signs of sepsis. Medical resource utilization, clinical outcomes, and E. coli isolate characteristics were descriptively reported during the first IED encounter and during the following year (observation period). Results Overall, 19,773 patients with IED were included (mean age: 76.8 years; 67.4% female; 78.5% with signs of sepsis). Most encounters involved community-onset IED (94.3%) and required hospitalization (96.5%; mean duration: 6.9 days), with 32.4% of patients being admitted to the intensive care unit (mean duration: 3.7 days). Most E. coli isolates were resistant to ≥ 1 antibiotic category (61.7%) and 34.4% were resistant to ≥ 3 antibiotic categories. Following their first IED encounter, 34.8% of patients were transferred to a skilled nursing/intermediate care facility, whereas 6.8% had died. During the observation period, 36.8% of patients were rehospitalized, 2.4% had IED recurrence, and in-hospital death increased to 10.9%. Conclusions IED is associated with substantial clinical burden at first encounter with considerable long-term consequences. Findings demonstrate the need for increased IED awareness and highlight potential benefits of prevention.https://doi.org/10.1186/s12879-023-08479-3Invasive Escherichia coli diseaseMedical resource utilizationTreatment patternsAntibiotic resistanceCase fatality rate |
| spellingShingle | Luis Hernandez-Pastor Jeroen Geurtsen Bryan Baugh Antoine C. El Khoury Nnanya Kalu Marjolaine Gauthier-Loiselle Rebecca Bungay Martin Cloutier Michal Sarnecki Elie Saade Clinical burden of invasive Escherichia coli disease among older adult patients treated in hospitals in the United States BMC Infectious Diseases Invasive Escherichia coli disease Medical resource utilization Treatment patterns Antibiotic resistance Case fatality rate |
| title | Clinical burden of invasive Escherichia coli disease among older adult patients treated in hospitals in the United States |
| title_full | Clinical burden of invasive Escherichia coli disease among older adult patients treated in hospitals in the United States |
| title_fullStr | Clinical burden of invasive Escherichia coli disease among older adult patients treated in hospitals in the United States |
| title_full_unstemmed | Clinical burden of invasive Escherichia coli disease among older adult patients treated in hospitals in the United States |
| title_short | Clinical burden of invasive Escherichia coli disease among older adult patients treated in hospitals in the United States |
| title_sort | clinical burden of invasive escherichia coli disease among older adult patients treated in hospitals in the united states |
| topic | Invasive Escherichia coli disease Medical resource utilization Treatment patterns Antibiotic resistance Case fatality rate |
| url | https://doi.org/10.1186/s12879-023-08479-3 |
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