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Volume 13, Number 12—December 2007

Research

Invasive Group A Streptococcal Infection in Older Adults in Long-term Care Facilities and the Community, United States, 1998–20031

Michael C. Thigpen*Comments to Author , Chesley L. Richards*, Ruth Lynfield†, Nancy L. Barrett‡, Lee H. Harrison§, Kathryn E. Arnold¶, Arthur Reingold#, Nancy M. Bennett**, Allen S. Craig††, Ken Gershman‡‡, Paul R. Cieslak§§, Paige Lewis*, Carolyn M. Greene*, Bernard Beall*, Chris A. Van Beneden*, and for the Active Bacterial Core surveillance/Emerging Infections Program Network
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †Minnesota Department of Health, Minneapolis, Minnesota, USA; ‡Connecticut Department of Public Health, Hartford, Connecticut, USA; §Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; ¶Georgia Department of Human Resources, Atlanta, Georgia, USA; #University of California at Berkeley School of Public Health, Berkeley, California, USA; **University of Rochester School of Medicine and Dentistry, Rochester, New York, USA; ††Tennessee Department of Health, Nashville, Tennessee, USA; ‡‡Colorado Department of Public Health and Environment, Denver, Colorado, USA; §§Oregon State Public Health, Portland, Oregon, USA; 1Presented at the 42nd Annual Meeting of the Infectious Diseases Society of America, September 30–October 3, 2004, Boston, Massachusetts, USA.;

Main Article

Table 2

Characteristics of persons age >65 y with invasive group A streptococcal infection by known residence, ABCs areas, 1998–2003*

Characteristic No. LTCF 
case-patients (%), n = 383 No. community-based 
case-patients (%), n = 1,279 p value
Age, y <0.01
65–74 72 (18.8) 584 (45.7)
75–84 149 (38.9) 465 (36.3)
>85
162 (42.3)
230 (18.0)

Female sex
238 (62.1)
626 (48.9)
<0.01
Race† 0.16
White 282 (82.5) 914 (78.9)
Black 50 (14.6) 182 (15.7)
Other
10 (2.9)
63 (5.4)

Case-fatality† 124 (32.6) 268 (21.1) <0.01
Hospitalization† 346 (90.3) 1211 (94.8) <0.01
Presence of underlying illnesses†
Congestive heart failure 104 (29.3) 237 (20.5) <0.01
Cerebrovascular accident 39 (16.8) 71 (9.4) <0.01
Diabetes mellitus 86 (24.2) 346 (30.0) <0.05
Current smoker 6 (2.1) 61 (6.5) <0.01
Chronic obstructive pulmonary disease 62 (17.5) 172 (14.9) 0.24
Atherosclerotic cardiovascular disease 95 (26.7) 351 (30.4) 0.19
Renal failure/dialysis 30 (8.5) 103 (8.9) 0.78
Alcohol abuse 19 (5.4) 48 (4.2) 0.34
Immunosuppressive therapy‡ 19 (5.4) 87 (7.5) 0.16

*ABCs, Active Bacterial Core surveillance;LTCF, long-term care facility. Case-patients with missing responses for residence type or individual characteristics were excluded from analysis.
†Data were not available for all case-patients. Denominators by residence varied for the following: race (LTCF 342, community 1,159), outcome (LTCF 380, community 1,270), hospitalization (LTCF 383, community 1,278), underlying illnesses (LTCF 355, community 1,154) except for cerebrovascular accident (LTCF 232, community 758) and current smoker (LTCF 285, community 936).
‡Includes steroids, chemotherapy, and radiation therapy.

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1Presented at the 42nd Annual Meeting of the Infectious Diseases Society of America, September 30–October 3, 2004, Boston, Massachusetts, USA.

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