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Volume 13, Number 12—December 2007


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 5

Results of multivariate logistic regression analysis of factors associated with death from invasive group A streptococcal infection among case-patients >65 y of age, ABCs areas, 1998–2003*

Characteristic Adjusted odds ratio (95% CI)
Age group, y
>85 1.4 (0.9–2.1)
75–84 1.2 (0.8–1.8)
65–74 Reference
Black 0.8 (0.5–1.2)
Other than black
Long-term care facility 1.6 (1.1–2.2)
Community Reference
Hospitalized 0.5 (0.3–0.9)
Not hospitalized
Bacteremia without focus 2.6 (1.7–3.8)
Pneumonia 3.7 (2.4–5.8)
Necrotizing fasciitis 3.6 (1.7–7.4)
STSS 11.1 (6.4–19.3)
Other syndrome
emm type
emm1 2.3 (1.4–3.6)
emm3 1.9 (1.1–3.1)
emm4 1.7 (0.6–4.5)
emm6 0.6 (0.2–2.1)
emm11 0.4 (0.1–2.0)
emm12 1.9 (1.1–3.4)
emm18 1.3 (0.5–3.9)
emm28 0.9 (0.5–1.7)
emm77 1.3 (0.5–3.4)
emm89 1.5 (0.8–3.0)
Other emm types
Sex and history of CHF†
Females with CHF 2.4 (1.5–3.8)
Females without CHF 0.9 (0.7–1.4)
Males with CHF 1.2 (0.7–2.0)
Males without CHF Reference

*ABCs, Active Bacterial Core Surveillance; CI, confidence interval; STSS, streptococcal toxic shock syndrome; CHF, congestive heart failure. A total of 1,140 case-patients with complete data were included in the final model. Significant results are shown in boldface.
†Interaction between sex and history of CHF.

Main Article

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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