Low but Increasing Prevalence of Reduced Beta-lactam Susceptibility Among Invasive Group B Streptococcal Isolates, US Population-Based Surveillance, 1998-2018.

Background: Invasive group B (iGBS) isolates with mutations in the gene that encodes penicillin binding protein 2x can have reduced beta-lactam susceptibility (RBLS) when susceptible by Clinical and Laboratory Standards Institute (CLSI) criteria. We assessed the emergence and characteristics of RBLS strains in US iGBS isolates.

Methods: We analyzed iGBS isolates from 8 multistate population-based surveillance sites from 1998 to 2018.

Multistate, Population-Based Distributions of Candidate Vaccine Targets, Clonal Complexes, and Resistance Features of Invasive Group B Streptococci Within the United States, 2015-2017.

Background: Group B Streptococcus (GBS) is a leading cause of neonatal sepsis and meningitis and an important cause of invasive infections in pregnant and nonpregnant adults. Vaccines targeting capsule polysaccharides and common proteins are under development.

Methods: Using whole genome sequencing, a validated bioinformatics pipeline, and targeted antimicrobial susceptibility testing, we characterized 6340 invasive GBS isolates recovered during 2015-2017 through population-based Active Bacterial Core surveillance (ABCs) in 8 states.

Age-Related Differences in Hospitalization Rates, Clinical Presentation, and Outcomes Among Older Adults Hospitalized With Influenza-U.S. Influenza Hospitalization Surveillance Network (FluSurv-NET).

Background: Rates of influenza hospitalizations differ by age, but few data are available regarding differences in laboratory-confirmed rates among adults aged ≥65 years.

Methods: We evaluated age-related differences in influenza-associated hospitalization rates, clinical presentation, and outcomes among 19 760 older adults with laboratory-confirmed influenza at 14 FluSurv-NET sites during the 2011-2012 through 2014-2015 influenza seasons using 10-year age groups.

Results: There were large stepwise increases in the population rates of influenza hospitalization with each 10-year increase in age.

Short-Term Incidence of Sequelae of HCV Infection Among Medicaid Beneficiaries in Oregon.

Objectives: Given the known high morbidity and mortality of hepatitis C virus (HCV) infection in Oregon, we sought to develop a practical method of estimating the severe sequelae of HCV infection among Medicaid beneficiaries in Oregon.

Methods: We assembled a retrospective cohort that identified all Oregon Medicaid beneficiaries with HCV infection enrolled for at least 1 year during 2009-2013. We linked this cohort to 3 data sets to identify HCV-related deaths, cases of hepatocellular carcinoma (HCC), and first hospitalizations for advanced liver disease (ALD).

Assessing the effectiveness of high-dose influenza vaccine in preventing hospitalization among seniors, and observations on the limitations of effectiveness study design.

Background: The availability of high-dose (HD) influenza vaccine for seniors should decrease influenza-related hospitalization. Studies to date show a range of mostly moderate increased HD vaccine effectiveness (VE). While a 'healthy vaccinee' phenomenon can inflate VE, for influenza and particularly an HD vaccine targeted at frailer adults, an 'at-risk vaccinee' bias may deflate VE estimates.

Impact of pregnancy on observed sex disparities among adults hospitalized with laboratory-confirmed influenza, FluSurv-NET, 2010-2012.

Introduction: Previous FluSurv-NET studies found that adult females had a higher incidence of influenza-associated hospitalizations than males. To identify groups of women at higher risk than men, we analyzed data from 14 FluSurv-NET sites that conducted population-based surveillance for laboratory-confirmed influenza-associated hospitalizations among residents of 78 US counties.

Methods: We analyzed 6292 laboratory-confirmed, geocodable (96%) adult cases collected by FluSurv-NET during the 2010-12 influenza seasons.

Statewide validation of hospital-reported central line-associated bloodstream infections: Oregon, 2009.

Background: Mandatory reporting of healthcare-associated infections is common, but underreporting by hospitals limits meaningful interpretation.

Objective: To validate mandatory intensive care unit (ICU) central line-associated bloodstream infection (CLABSI) reporting by Oregon hospitals.

Design: Blinded comparison of ICU CLABSI determination by hospitals and health department-based external reviewers with group adjudication.

Association between use of statins and mortality among patients hospitalized with laboratory-confirmed influenza virus infections: a multistate study.

Background: Statins may have anti-inflammatory and immunomodulatory effects that could reduce the risk of mortality from influenza virus infections.

Methods: The Centers for Disease Control and Prevention's Emerging Infections Program conducts active surveillance for persons hospitalized with laboratory-confirmed influenza in 59 counties in 10 states. We analyzed data for hospitalized adults during the 2007-2008 influenza season to evaluate the association between receiving statins and influenza-related death.

Geographic variation in invasive pneumococcal disease following pneumococcal conjugate vaccine introduction in the United States.

Background: Rates of invasive pneumococcal disease (IPD) varied among the United States before pneumococcal conjugate vaccine (PCV7) introduction. We compared trends in IPD rates among diverse US sites over 10 years since PCV7 introduction.

Methods: Patients with IPD of all ages were identified through active population and laboratory-based surveillance in 8 geographic areas under continuous surveillance during 1998-2009.

Prevention of invasive pneumococcal disease among HIV-infected adults in the era of childhood pneumococcal immunization.

Objective: Human immunodeficiency virus (HIV) infection and AIDS increase the risk of invasive pneumococcal disease (IPD). We evaluated IPD among HIV-infected adults over a 10-year period in the US to identify opportunities for prevention of IPD among HIV-infected adults.

Design: IPD and HIV surveillance in seven population-based and laboratory-based Active Bacterial Core surveillance areas.

Influenza testing and antiviral prescribing practices among emergency department clinicians in 9 states during the 2006 to 2007 influenza season.

Study Objective: Influenza causes significant widespread illness each year. Emergency department (ED) clinicians are often first-line providers to evaluate and make treatment decisions for patients presenting with influenza. We sought to better understand ED clinician testing and treatment practices in the Emerging Infections Program Network, a federal, state, and academic collaboration that conducts active surveillance for influenza-associated hospitalizations.

Complementary and alternative medicine use in chronic liver disease patients.

Goals: To examine a wide range of sociodemographic and clinical characteristics as potential predictors of complementary and alternative medicine (CAM) use among chronic liver disease (CLD) patients, with a focus on CAM therapies with the greatest potential for hepatotoxicity and interactions with conventional treatments.

Background: There is some evidence that patients with CLD commonly use CAM to address general and CLD-specific health concerns.

Study: Patients enrolled in a population-based surveillance study of persons newly diagnosed with CLD between 1999 and 2001 were asked about current use of CAM specifically for CLD.

Evaluation of universal antenatal screening for group B streptococcus.

Background: Group B streptococcal disease is one of the most common infections in the first week after birth. In 2002, national guidelines recommended universal late antenatal screening of pregnant women for colonization with group B streptococcus to identify candidates for intrapartum chemoprophylaxis.

Methods: We evaluated the implementation of the guidelines in a multistate, retrospective cohort selected from the Active Bacterial Core surveillance, a 10-state, population-based system that monitors invasive group B streptococcal disease.

Population snapshot of emergent Streptococcus pneumoniae serotype 19A in the United States, 2005.

Background: Serotype 19A invasive pneumococcal disease (IPD) increased annually in the United States after the introduction of the 7-valent conjugate vaccine (PCV7). To understand this increase, we characterized serotype 19A isolates recovered during 2005.

Methods: IPD cases during 1998-2005 were identified through population-based surveillance.

Deaths from chronic liver disease and viral hepatitis, Multnomah County, Oregon, 2000.

Goals: Identify deaths related to chronic liver disease (CLD) in 2000 among Multnomah County, Oregon residents and estimate the proportion of these deaths attributable to hepatitis B or hepatitis C.

Background: Although CLD is among the most common causes of mortality in the United States, little information is available regarding the proportion of CLD mortality attributable to viral hepatitis.

Study: We developed a comprehensive list of 117 International Classification of Disease-10 codes potentially related to CLD.

Invasive pneumococcal disease among infants before and after introduction of pneumococcal conjugate vaccine.

Context: Streptococcus pneumoniae is a serious infection in young infants. A heptavalent pneumococcal conjugate vaccine (PCV7) was licensed in 2000 and recommended for all children aged 2 to 23 months.

Objective: To determine the rates of invasive pneumococcal disease (IPD) in young infants before and after PCV7 was incorporated into the childhood immunization schedule in June 2000.

Effect of introduction of the pneumococcal conjugate vaccine on drug-resistant Streptococcus pneumoniae.

Background: Five of seven serotypes in the pneumococcal conjugate vaccine, introduced for infants in the United States in 2000, are responsible for most penicillin-resistant infections. We examined the effect of this vaccine on invasive disease caused by resistant strains.

Methods: We used laboratory-based data from Active Bacterial Core surveillance to measure disease caused by antibiotic-nonsusceptible pneumococci from 1996 through 2004.

Changes in invasive Pneumococcal disease among HIV-infected adults living in the era of childhood pneumococcal immunization.

Background: Adults infected with HIV have high rates of invasive pneumococcal disease. Introduction of pneumococcal conjugate vaccine for children could affect disease among HIV-infected adults.

Objective: To compare invasive pneumococcal disease among HIV-infected adults before and after the introduction of a pediatric conjugate vaccine.

Transmission of hepatitis C virus to several organ and tissue recipients from an antibody-negative donor.

Background: Although hepatitis C virus (HCV) transmission through tissue transplantation has been rarely reported, a donor with undetected viremia may infect several recipients. A patient developed acute hepatitis C shortly after tissue transplantation. Ninety-one tissues or organs had been recovered from the donor.

Seroprevalence of hepatitis B and C in juvenile detention entrants, Oregon, 1994-1996.

We tested sera originally collected from 1335 juvenile detention entrants for an HIV study in 1994-1996 for hepatitis B virus (HBV) and hepatitis C virus (HCV) antibodies; we found that the seroprevalence of HBV and HCV antibody was 2% and 1%, respectively. HBV was associated with Asian race, whereas HCV infection was associated with injection drug use and female gender.

Hepatitis B vaccine coverage among infants born to women without prenatal screening for hepatitis B virus infection: effects of the Joint Statement on Thimerosal in Vaccines.

Background: As a result of controversy about mercury exposures from vaccines containing thimerosal, the American Academy of Pediatrics and the US Public Health Service recommended in July 1999 that the first dose of hepatitis B vaccine be deferred until 2 to 6 months of age, but only for infants born to hepatitis B surface antigen (HBsAg)-negative women. We investigated the effect of these recommendation changes on the management of Oregon infants born to women whose HBsAg status was "unknown."

Methods: Infants were identified by reviewing electronic birth certificate data from 34 Oregon hospitals during (1)April through June 1999 [before recommendation changes (T1)], (2) August through October 1999 [after recommendations changes (T2)] and (3) April through June 2000 [when resumption of pre-1999 practices were recommended (T3)].