Journal Article

A qualitative burden of disease study in patients with invasive Escherichia coli disease aged ≥ 60 years in the United States

Schmidt, Mark A., Gruß, Inga, McQuarrie, Kelly, Sarnecki, Michal, Pastor, Luis Hernandez, Geurtsen, Jeroen, Verstraeten, Thomas, Doua, Joachim, Donald, Judy, Valencia, Cristina, El Khoury, Antoine C., Carrió, Elvira, Davis, James V.

2025

Overview

Background Invasive Escherichia coli disease (IED) comprises a diverse range of severe infections caused by E. coli , mainly affecting neonates and older adults, and is associated with severe and sometimes fatal outcomes. This study aimed to evaluate signs and symptoms associated with IED, and to assess the impact of IED on health-related quality of life (HRQoL) among older patients. Furthermore, we examined how generic patient-reported outcomes questionnaires capture experiences of patients with IED. Methods A cross-sectional qualitative study consisting of semi-structured interviews was conducted. Participants aged ≥ 60 years who met the IED clinical case definition were enrolled within 2 weeks after the disease episode and asked to describe IED signs and symptoms and HRQoL impact through open-ended questions. The interview transcripts were analyzed using NVivo 12 and a conceptual model was built. The concepts for impacts identified by participants with IED were then compared with the concepts routinely assessed by two generic HRQoL instruments: the 36-Item Short Form Survey (SF-36) and EuroQol 5-Dimension (EQ-5D). Results Of 80 patients screened, 43 met inclusion criteria and 16 consented to participate in the study. The interviews showed that IED affected daily routines and activities ( n  = 13), ability to move and sleep (both n  = 11), and caused exhaustion ( n  = 10) as well as constant pain ( n  = 9). Most HRQoL impacts identified were also measured in SF-36 and EQ-5D, but concepts specific for patients with IED, not measured in SF-36 and EQ-5D, were also recognized. Conclusions IED was shown to cause substantial physical, social, and psychological impacts in patients. This burden was especially apparent in review of patient self-reports for concepts that are part of generic HRQoL instruments (SF-36, EQ-5D), and patients also frequently reported neurological/mental impacts. Further, this study provides valuable qualitative data that may be useful for future research in developing a disease-specific instrument for the assessment of HRQoL in patients with IED.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Abscesses / Aged / Aged, 80 and over / Analysis / Bacteremia / Bacterial infections / Blood / Care and treatment / Complications and side effects / Consent / Cost of Illness / Cross-Sectional Studies / Demographic aspects / Demographics / Development and progression / E coli / Electronic health records / Escherichia coli / Escherichia coli infections / Escherichia coli Infections - epidemiology / Escherichia coli Infections - microbiology / Escherichia coli Infections - psychology / Exhaustion / Feedback / Female / Gastroenteritis / Health aspects / Hospital costs / Hospitalization / Humans / Infectious Diseases / Internal Medicine / Interviews / Invasive E. coli disease (IED) / Male / Medical Microbiology / Medical records / Medical research / Medicine / Medicine & Public Health / Middle Aged / Multidrug resistant organisms / Neonates / Older people / Parasitology / Pathogens / Patient outcomes / Patient-reported outcomes / Patients / Pneumonia / Qualitative analysis / Qualitative Research / Quality of Life / Sepsis / Signs and symptoms / Surveys / Surveys and Questionnaires / Tropical Medicine / United States - epidemiology / Urinary tract infections