Published data on the epidemiology of idiopathic thrombocytopenic purpura (ITP) among adults are very limited. We conducted a study of ITP incidence using the General Practice Research Database in the United Kingdom. From 1992 to 2005, there were 840 cases of ITP among adults considering 21 749 623 person-years (PYs) of follow-up, for a crude incidence of 3.9 per 100 000 PYs [95% confidence interval (CI): 3.6, 4.1]. The incidence was higher among women [4.5 per 100 000 PYs (95% CI: 4.2, 4.9)] than men [3.2 per 100 000 PYs (95% CI: 2.8, 3.5)]. Among both women and men, incidence was higher at older ages and in later study years. In a systematic review of previously published literature, incidence of ITP among adults ranged from 1.6 to 2.68 per 100 000 persons per year; prevalence ranged from 9.5 to 23.6 per 100 000 persons. In order to improve the understanding of the disease burden of ITP, future studies should include a clearly defined definition of ITP and focus on well-described source populations that are geographically and ethnically diverse.

Background Uncomplicated urinary tract infection (uUTI) is predominantly caused by Escherichia coli, which has increasing antimicrobial resistance (AMR) at the US-community level. As uUTI is often treated empirically, assessing AMR is challenging and there are limited contemporary data characterizing period prevalence in the US. Methods This was a retrospective study of AMR using Becton, Dickinson and Company Insights Research Database (Franklin Lakes, NJ) data collected 2011–2019. Thirty-day, non-duplicate Escherichia coli urine isolates from US female outpatients (aged ≥12 years) were included. Isolates were evaluated for not-susceptibility (intermediate/resistant) to trimethoprim-sulfamethoxazole, fluoroquinolones, or nitrofurantoin, and assessed for extended-spectrum β-lactamase production (ESBL+) and for ≥2 or ≥3 drug-resistance phenotypes. Generalized estimating equations were used to model AMR trends over time and by US census region. Results Among 1,513,882 Escherichia coli isolates, the overall prevalence of isolates not-susceptible to trimethoprim-sulfamethoxazole, fluoroquinolones, and nitrofurantoin was 25.4%, 21.1%, and 3.8%, respectively. Among the isolates, 6.4% were ESBL+, 14.4% had ≥2 drug-resistance phenotypes, and 3.8% had ≥3. Modelling demonstrated a relative average yearly increase of 7.7% (95% confidence interval [CI], 7.2–8.2%) for ESBL+ isolates and 2.7% (95% CI, 2.2–3.2%) for ≥3 drug-phenotypes (both p<0.0001). Modelling also demonstrated significant variation in AMR prevalence between US census regions (p<0.001). Conclusions Period prevalence of AMR among US outpatient urine-isolated Escherichia coli was high, and for multi-drug-resistance phenotypes increased during the study period with significant variation between census regions. Knowledge of regional AMR rates helps inform empiric treatment of community-onset uUTI and highlights the AMR burden to physicians.

The majority of case reports with NDM-1-producing bacteria had presumed colonization, not infection, with one or more bacteria. The available human case reports and surveillance data suggest a global distribution of NDM-1-producing Enterobacteriaceae and non-Enterobacteriaceae.