Biology subjects

Viboud, C.

Publications and source records attributed to Viboud, C..

4 recordsLinked to original sources

bioRxiv2018

Levels of prescribing for four major antibiotic classes and rates of septicemia hospitalization in different US states

BackgroundRates of sepsis/septicemia hospitalization in the US have risen significantly during recent years, and antibiotic resistance and use may contribute to those rates through various mechanisms.\n\nMethodsWe used multivariable linear regression to relate state-specific rates of outpatient prescribing overall for fluoroquinolones, penicillins, macrolides, and cephalosporins between 2011-2012 to state-specific rates of hospitalization with septicemia (ICD-9 codes 038.xx present anywhere on discharge diagnosis) in each of the following age groups of adults: (18-49y, 50-64y, 65-74y, 75-84y, 85+y) reported to the Healthcare Cost and Utilization Project (HCUP) between 2011-2012, adjusting for additional covariates, and random effects associated with the ten US Health and Human Services (HHS) regions.\n\nResultsRates of penicillin prescribing were positively associated with septicemia hospitalization rates in the analyses for persons aged 50-64y, 65-74y, and 74-84y. Percent African Americans in a given age group was positively associated with septicemia hospitalization rates in the analyses for persons aged 75-84y and over 85y. Average minimal daily temperature was positively associated with septicemia hospitalization rates in the analyses for persons aged 18-49y, 50-64y, 75-84y and over 85y.\n\nConclusionsOur results suggest positive associations between the rates of prescribing for penicillins and the rates of sepsis hospitalization in US adults aged 50-84y. Further studies are needed to understand the potential effect of antibiotic replacement in the treatment of various syndromes, such as replacement of fluoroquinolones by other antibiotics, possibly penicillins following the recent US FDA guidelines on restriction of fluoroquinolone use, on the rates of sepsis hospitalization.

epidemiology↗

bioRxiv2018

Antimicrobial resistance prevalence and rates of hospitalization with septicemia in the diagnosis in adults in different US states

ObjectivesRates of hospitalization with sepsis/septicemia and associated mortality in the US have risen significantly during the last two decades. Antibiotic resistance may contribute to the rates of sepsis-related outcomes through lack of clearance of bacterial infections following antibiotic treatment during different stages of infection. However, there is limited information about the relation between prevalence of resistance to various antibiotics in different bacteria and rates of sepsis-related outcomes. MethodsFor different age groups of adults (18-49y,50-64y,65-74y,75-84y,85+y) and combinations of antibiotics/bacteria, we evaluated associations between state-specific prevalence (percentage) of resistant samples for a given combination of antibiotics/bacteria among catheter-associated urinary tract infections in the CDC Antibiotic Resistance Patient Safety Atlas data between 2011-2014 and rates of hospitalization with septicemia (ICD-9 codes 038.xx present on the discharge diagnosis) reported to the Healthcare Cost and Utilization Project (HCUP), as well as rates of mortality with sepsis (ICD-10 codes A40-41.xx present on death certificate). ResultsAmong the different combinations of antibiotics/bacteria, prevalence of resistance to fluoroquinolones in E. coli had the strongest association with septicemia hospitalization rates for individuals aged over 50y, and with sepsis mortality rates for individuals aged 18-84y. A number of positive correlations between prevalence of resistance for different combinations of antibiotics/bacteria and septicemia hospitalization/sepsis mortality rates in adults were also found. ConclusionsOur findings, as well as our related work on the relation between antibiotic use and sepsis rates support the association between resistance to/use of certain antibiotics and rates of sepsis-related outcomes, suggesting the potential utility of antibiotic replacement.

epidemiology↗

bioRxiv2017

On the relative role of different age groups during epidemics associated with the respiratory syncytial virus

BackgroundWhile RSV circulation results in high burden of hospitalization, particularly among infants, young children and the elderly, little is known about the role of different age groups in propagating annual RSV epidemics in the community.\n\nMethodsDuring a communicable disease outbreak, some subpopulations may play a disproportionate role during the outbreak's ascent due to increased susceptibility and/or contact rates. Such subpopulations can be identified by considering the proportion that cases in a subpopulation represent among all cases in the population occurring before (Bp) and after the epidemic peak (Ap) to calculate the subpopulation's relative risk, RR=Bp/Ap. We estimated RR for several age groups using data on RSV hospitalizations in the US between 2001-2012 from the Healthcare Cost and Utilization Project (HCUP).\n\nResultsChildren aged 3-4y and 5-6y each had the highest RR estimate for 5/11 seasons in the data, with RSV hospitalization rates in infants being generally higher during seasons when children aged 5-6y had the highest RR estimates. Children aged 2y had the highest RR estimate during one season. RR estimates in infants and individuals aged 11y and older were mostly lower than in children aged 1-10y.\n\nConclusionsThe RR estimates suggest that preschool and young school-age children have the leading relative roles during RSV epidemics. We hope that those results will aid in the design of RSV vaccination policies.

epidemiology↗

bioRxiv2017

Socio-environmental and measurement factors drive spatial variation in influenza-like illness

The mechanisms hypothesized to drive spatial heterogeneity in reported influenza activity include: environmental factors, contact patterns, population age structure, and socioeconomic factors linked to healthcare access and quality of life. Harnessing the large volume and high specificity of diagnosis codes in medical claims data for influenza seasons from 2002-2009, we estimate the importance of socio-environmental determinants and measurement-related factors on observed variation in influenza-like illness (ILI) across United States counties. We found that South Atlantic states tended to have higher ILI seasonal intensity, and a combination of transmission, environmental, influenza subtype, socioeconomic and measurement factors explained the variation in seasonal intensity across our study period. Moreover, our models suggest that sentinel surveillance systems should have fixed report locations across years for the most robust inference and prediction, and high volumes of data can offset measurement biases in opportunistic data samples.

epidemiology↗