Document Detail


Invasive pneumococcal disease in older adults residing in long-term care facilities and in the community.
MedLine Citation:
PMID:  14687379     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To examine the epidemiology of invasive pneumococcal disease in older adults hospitalized for invasive pneumococcal disease who are living in the community and in long-term care facilities (LTCFs) in the United States. DESIGN: Analysis of 2402 cases of invasive pneumococcal disease requiring hospitalization in 2000 and 2001 that the Centers for Disease Control and Prevention's Active Bacterial Core Surveillance collected in nine states. SETTING: Hospital. PARTICIPANTS: Hospitalized LTCF residents and community-living older adults in the United States. MEASUREMENTS: Age- and residence-specific pneumococcal disease incidence rates per 100000 persons, case-fatality rates, and trends in antimicrobial resistance. RESULTS: Nationally, the rate of invasive pneumococcal disease in LTCF residents was 194.2 cases per 100000 persons aged 65 and older and 44.6 for community-living older adults (relative risk=4.4, 95% confidence interval (CI)=4.2-4.5). Compared with community-living older adults, case-fatality rates were 1.9 times higher (30.8% vs 16.0%, 95% CI=1.5-2.5). Pneumococcal strains from LTCF residents were significantly more likely to be nonsusceptible to levofloxacin than strains from community- living older adults (5.7% vs 0.4%, P<.001). CONCLUSION: Older adults living in LTCFs are at a higher risk for invasive pneumococcal disease and death than are community-living older adults. Additionally, fluoroquinolone resistance is significantly higher in older adults living in LTCFs and may provide clues to emerging antimicrobial resistance in the general population.
Authors:
Benjamin A Kupronis; Chesley L Richards; Cynthia G Whitney;
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Journal of the American Geriatrics Society     Volume:  51     ISSN:  0002-8614     ISO Abbreviation:  J Am Geriatr Soc     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-12-22     Completed Date:  2004-02-09     Revised Date:  2008-03-10    
Medline Journal Info:
Nlm Unique ID:  7503062     Medline TA:  J Am Geriatr Soc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1520-5     Citation Subset:  IM    
Affiliation:
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. bbk3@cdc.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Female
Health Surveys
Humans
Incidence
Male
Microbial Sensitivity Tests
Pneumococcal Infections / epidemiology,  microbiology,  mortality*
Residential Facilities
Retrospective Studies
Streptococcus pneumoniae / isolation & purification
Survival Rate
United States / epidemiology
Comments/Corrections
Comment In:
J Am Geriatr Soc. 2003 Nov;51(11):1669-70   [PMID:  14687402 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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