Identifying Sepsis From Foodborne Hospitalization: Incidence and Hospitalization Cost by Pathogen

Abstract

Background Sepsis causes a major health burden in the United States. To better understand the role of sepsis as a driver of the burden and cost of foodborne illness in the United States, we estimated the frequency and treatment cost of sepsis among U.S. patients hospitalized with 31 pathogens commonly transmitted through food or with unspecified AGI. Methods Using data from the National Inpatient Sample from 2012-2015, we identified sepsis hospitalizations using two approaches— explicit ICD-9-CM codes for sepsis and a coding scheme developed by Angus that identifies sepsis using specific ICD-9-CM diagnosis codes indicating an infection plus organ failure. We examined differences in the frequency and the per-case cost of sepsis across pathogens and AGI and estimated total hospitalization costs using prior estimates of foodborne hospitalizations. Results Using Explicit Sepsis Codes, sepsis hospitalizations accounted for 4.6% of hospitalizations with a pathogen commonly transmitted through food or unspecified AGI listed as a diagnosis; this was 33.2% using Angus Sepsis Codes. The average per-case cost was $35,891 and $20,018, respectively. Applying the proportions of hospitalizations with sepsis from this study to prior estimates of the number foodborne hospitalizations, the total annual cost was $248 million annually using Explicit Sepsis Codes and $889 million using Angus Sepsis Codes. Conclusion Sepsis is a serious complication among patients hospitalized with a foodborne pathogen infection or AGI resulting in a large burden of illness. Hospitalizations that are diagnosed using explicit sepsis codes are more severe and costly, but likely underestimate the burden of foodborne sepsis.

Citrulline, Intestinal Fatty Acid-Binding Protein and the Acute Gastrointestinal Injury Score as Predictors of Gastrointestinal Failure in Patients with Sepsis and Septic Shock

“…It was developed by ESICM in 2012 [15] and validated in 2017 [2]. Many studies have used the AGI score as a major indication of intestinal dysfunction and failure in variety of clinical settings, e.g., in critically ill COVID-19 patients, in patients with foodborne sepsis, and to evaluate enteral feeding protocol in critically ill patients and gut rest strategy [46][47][48][49][50]. In the present study, biomarker levels measured on days 1, 3, 5, 7, and 10 were assessed by comparison with the severity of intestinal dysfunction determined by the AGI score on respective days.…”

Molecular Engineering Powered Dual-Readout Point-of-Care Testing for Sensitive Detection of Escherichia coli O157:H7

“…Foodborne diseases, caused by pathogenic bacteria such as Escherichia coli O157:H7 ( E. coli O157:H7), one of the most dangerous bacteria, are a major food safety and global health challenge, costing over 17.6 billion dollars and causing around 3400 deaths annually. , Historically, the detection of foodborne pathogens has relied primarily on culture, which requires a time-consuming process of 5–7 days with complicated steps including purification, cell plating, and biochemical and serological identification . Rapid and user-friendly tests are thus needed to accelerate foodborne pathogen detection.…”

Gold Nanoparticle-Based Colorimetric Biosensing for Foodborne Pathogen Detection

“…Pathogens transmitted through food and water can lead to a spectrum of infections, with outcomes spanning from mild fever to fatal consequences [ 2 , 3 , 4 ]. Annually in the United States, an estimated 48 million domestically acquired foodborne illnesses occur, leading to 127,839 hospitalizations and 3040 deaths, with a societal cost exceeding USD 17.6 billion [ 5 ]. Food regulatory agencies and manufacturers have diligently adopted numerous initiatives to reduce the risks associated with contamination by foodborne pathogens.…”