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Volume 9, Number 8—August 2003

Research

Invasive Group A Streptococcal Disease: Risk Factors for Adults

Stephanie H. Factor*†Comments to Author , Orin S. Levine‡, Benjamin Schwartz*, Lee H. Harrison§, Monica M. Farley¶, Allison McGeer#, and Anne Schuchat*
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †New York Academy of Medicine, New York, New York, USA; ‡National Institute for Allergy and Infectious Diseases, Bethesda, Maryland, USA; §Johns Hopkins University, Baltimore, Maryland, USA; ¶Emory University, Atlanta, Georgia; #Mount Sinai Hospital, Toronto, Ontario, Canada

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Table 4

Individual risk factor and multivariable analysis for risk factors for invasive group A streptococcal disease case-patients and control subjects, matched by age group and zip code, 45+ years old, Atlanta, Baltimore, Toronto, 1997–1999a,b,c

Variable Univariate analysis Multivariable analysis

Case-patients
(n=91)
Control subjects
(n=196)
OR (95% CI)
p value
OR (95% CI)
p value
Number of
persons
living in
the home
3+
1–2
47 (52)
44 (48)
55 (28)
140 (72)
2.64 (1.46 to 4.75)
0.001
2.68 (1.37 to 5.28)
0.004
Any child
living in
the home
Yes
No
31 (34)
60 (66)
33 (17)
163 (83)
2.12 (1.11 to 4.05)
0.02


Smoke
exposure
Current
smoker
with passive
smoke
exposure

15 (16)
16 (8)
2.37 (0.94 to 6.01)
0.07


Current
smoker
without
passive
smoke
exposure

12 (13)
32 (16)
1.07 (0.49 to 2.33)
0.86


Passive
smoke
exposure

19 (21)
25 (13)
2.34 (1.08, 5.04)
0.03


No smoke
exposure

45 (49)
123 (63)
1.00



Diabetes
mellitus
Yes
No
28 (31)
62 (69)
32 (16)
164 (84)
2.33 (1.22 to 4.45)
0.01
2.27 (1.07 to 4.81)
0.03
Hypertension
Yes
No
47 (52)
42 (47)
86 (45)
107 (55)
1.61 (0.92 to 2.82)
.10


Cardiac disease
Yes
No
30 (33)
60 (67)
24 (12)
172 (88)
3.09 (1.58, 6.06)
0.001
3.24 (1.40 to 7.51)
0.006
Chronic
obstructive
pulmonary
disease (COPD)
Yes
No
8 (9)
79 (91)
2 (1)
193 (99)
7.85 (1.50 to 41.07)
0.01


Cancer
Yes
No
18 (20)
71 (80)
22 (11)
173 (89)
2.58 (1.23 to 5.41)
.01
3.54 (1.44 to 8.70)
0.006
Varicella
Yes
No
1 (1)
85 (99)
0
191 (100)
Undefined
.99


Cirrhosis
Yes
No
5 (6)
82 (94)
0
195 (100)
Undefined
0.99


Paralysis
Yes
No
5 (6)
84 (94)
1 (1)
195 (99)
11.61 (1.34 to 100.87)
0.01


Regular
NSAID
use
Yes
No
43 (48)
46 (52)
64 (34)
125 (66)
1.82 (1.06 to 3.14)
0.03


New use of
NSAIDs
Yes
No
14 (16)
72 (84)
14 (7)
178 (93)
2.13 (0.89 to 5.10)
0.09


Use of
cortico-
steroids
Yes
No
9 (10)
77 (90)
3 (2)
193 (98)
4.96 (1.26 to 19.62)
0.02
5.18 (1.14, 23.54)
.03
HIV+
Yes
No
1 (1)
90 (99)
2 (1)
194 (99)
.51 (0.04 to 6.14)
0.59


Ever
injected
drugs
Yes
No
6 (7)
78 (93)
3 (2)
190 (98)
5.48 (1.00 to 30.09)
0.05


Alcohol
use
based on
CAGE
questions
CAGE score 0
CAGE score 1
CAGE score 2
CAGE score 3
CAGE score 4 42 (78)
5 (9)
2 (4)
3 (6)
2 (4) 107 (77)
19 (14)
9 (6 )
4 (3)
0 0.95 (0.56 to 1.61) .86

aOR, odds ratio; CI, confidence interval; NSAID, nonsteroidal anti-inflammatory drug;
bDue to missing data, for some variables, data for fewer than 91 case-patients and 196 control subjects were available.
cAnalyses controlled for race and sex.

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