Demographic Risk Factors of Mortality among Non-Pregnant Adults with Invasive Group B Streptococcal Infection: Data from New Mexico Active Bacterial Surveillance, 2004-2009 Público

Reno, Jessica Renee (2011)

Permanent URL: https://etd.library.emory.edu/concern/etds/8910jv27b?locale=pt-BR
Published

Abstract

Group B Streptococcus (GBS) has emerged as an important cause of invasive infection in
non-pregnant adults since the 1970s. Active-, population-, and laboratory-based
surveillance for GBS began in 1997 through Active Bacterial Core surveillance (ABCs),
a core component of the Emerging Infections Program (EIP) network at the Centers for
Disease Control and Prevention (CDC). In 2004, the state of New Mexico (NM) joined
the EIP network. The purpose of this study was to determine demographic risk factors
for mortality among non-pregnant NM adults with invasive GBS infection between
January 1, 2004 and December 31, 2009 using NM's ABCs surveillance data. During
this time period, there were 641 cases of invasive GBS infection among non-pregnant
adults living in the state of NM. Of the 628 cases with known outcome, 68 (10.8%) died
as a result of infection. The risk of mortality according to age, gender, health insurance
status, race/ethnicity, and region of residence was assessed using SAS version 9.2. None
of these demographic characteristics were significant (p<0.05) predictors of mortality in
the univariate analysis of each characteristic or in the multivariate logistic regression
including all demographic characteristics and known risk factors for mortality. The
demographic groups with the highest mortality in NM from 2004 to 2009 were those
without health insurance (16.7%), those living in the southeast (15.9%) or southwest
(13.3%) region of the state, and those who were not American Indian (non-Hispanic
White: 12.5%; Hispanic: 13.0%). In order to prevent deaths due to invasive GBS
infection, it is important to further examine why these disparities exist and whether they
exist in other populations.

Table of Contents


1. Background. 1

1.1 Introduction. 1

1.2 Streptococcal Infections. 1

1.3 Etiology of Invasive Group B Streptococcal Infection among Adults. 3

1.4 Epidemiology of Invasive Group B Streptococcal Infection among Neonates. 4

1.5 Epidemiology of Invasive Group B Streptococcal Infection among Adults. 5

1.6 Treatment of Invasive Group B Streptococcal Infection. 6

1.7 Prevention of Invasive Group B Streptococcal Infection. 7

1.8 Known Risk Factors of Invasive Group B Streptococcal Infection among Adults. 8

1.9 Evidence-Based Risk Factors of Mortality among Adult Cases of Invasive Group B Streptococcal Infection 12

2. Methods. 14

2.1 Study Design. 14

2.2 Study Setting. 14

2.3 Study Subjects. 15

2.4 Data Source. 15

2.5 Analysis. 16

3. Results. 20

3.1 Population Characteristics. 20

3.2 Univariate Analysis. 22

3.3 Multivariate Analysis. 24

4. Discussion. 28

4.1 Results. 28

4.2 Strengths and Weaknesses. 33

4.3 Future Directions. 34

4.4 Conclusions. 36

References. 37

Appendices. 42

Appendix A: ABCs Case Report Form.. 43

Appendix B: Emory IRB Letter of Exemption 45

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