Feasibility of tracking invasive Escherichia coli disease among older adults in a community setting: A prospective observational study
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Published:2024-01-18
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Volume:
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ISSN:0934-9723
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Container-title:European Journal of Clinical Microbiology & Infectious Diseases
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language:en
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Short-container-title:Eur J Clin Microbiol Infect Dis
Author:
Doua JoachimORCID, Ekkelenkamp MiquelORCID, Verheij TheoORCID, Go Oscar, Ruhmel StephenORCID, Leathers Kimberly, Spiessens Bart, van Rooij Sanne, Fowler Vance G., Geurtsen Jeroen, Dolor RowenaORCID, Sarnecki MichalORCID, Chatterjee RaneeORCID, Poolman JanORCID, Bonten Marc,
Abstract
Abstract
Purpose
Invasive Escherichia coli disease (IED) encompasses a diverse range of sterile site infections. This study evaluated the feasibility of capturing IED among community-dwelling older adults to inform the implementation of a phase 3 efficacy trial of a novel vaccine against IED (NCT04899336).
Methods
EXPECT-1 (NCT04087681) was a prospective, multinational, observational study conducted in medically stable participants aged ≥ 60 years. At least 50% of participants were selected based on a history of urinary tract infection (UTI) in the previous 10 years. The main outcomes were the incidence of IED and the number of hospitalisations reported by the site vs participant. The length of follow-up was 12 months. In a US-based substudy, a smartphone-based geofencing was evaluated to track hospital entries.
Results
In total, 4470 participants were enrolled (median age, 70.0 years); 59.5% (2657/4469) of participants had a history of UTI in the previous 10 years. Four IED events were captured through deployment of different tracking methods: a self-report, a general practitioner (GP) report, and a follow-up call. The incidence rate of IED was 98.6 events per 100,000 person-years. The number of reported hospitalisations was 2529/4470 (56.6%) by the site and 2177/4470 (48.7%) by participants; 13.8% of hospitalisations would have been missed if utilising only site reports. Geofencing detected 72 hospital entries.
Conclusion
Deployment of multiple tracking methods can optimise detection of IED among community-dwelling older adults. Older adults with a history of UTI could be feasibly targeted for a phase 3 vaccine efficacy trial through a network of GPs.
Funder
Innovative Medicines Initiative
Publisher
Springer Science and Business Media LLC
Subject
Infectious Diseases,Microbiology (medical),General Medicine
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