899. Incidence of Community-acquired Pneumonia (CAP) Hospitalizations among Children and Adults in the United States: Data from the CDC Etiology of Pneumonia in the Community (EPIC) Study
Session: Poster Abstract Session: Respiratory Infections
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
  • Jain_EPIC_Incidence_IDSA_2013_final.pdf (277.7 kB)
  • Background: CAP is a common cause of hospitalization, yet contemporary rates of CAP hospitalization, based on prospective clinical studies, and the relative contributions of different pathogens based on sensitive diagnostics are not well defined. Using traditional and novel methods, the CDC EPIC study aims to determine population-based incidence of CAP hospitalization among children and adults.  

    Methods: Children (<18 years old) and adults with CAP admitted to eight pediatric and adult hospitals in Chicago, Memphis, Nashville, and Salt Lake City were enrolled.  CAP was defined as an acute respiratory infection with a new radiographic infiltrate in a patient requiring hospitalization residing in the catchment without recent hospitalization or severe immunosuppression.  Blood, urine, and respiratory specimens were systematically collected for multi-pathogen testing.  To calculate incidence, the number of CAP patients enrolled was adjusted by the percent enrolled and percent market share of catchment hospitals and divided by the respective population estimates.

    Results: From July 1, 2010 to June 30, 2012, 2257 (70%) of 3241 eligible children and 2210 (70%) of 3181 eligible adults were enrolled.  The majority were white (44%) or black (37%).  Most children were < 5 years old (69%).  Adults were 18-49 (30%), 50-64 (34%), and ≥65 years old (36%).  CAP incidence varied by year but was highest in patients < 5 years and ≥ 65 years old.


    Estimated Annual CAP Hospitalization Incidence Rate per 10,000 Population (95% confidence interval)

    by Age and Year

    Age in years

    July 1, 2010-June 30, 2011*

    July 1, 2011-June 30, 2012**


    49.7 (48-51.4)

    44.7 (43.0-46.4)


    6.2 (5.8-6.5)

    6.8 (6.4-7.2)


    9.3 (9.1-9.4)

    5.5 (5.4-5.6)


    31.8 (31.5-32.1)

    25.4 (25.1-25.7)


    123.2 (122.6-123.7)

    86.4 (86.0-86.9)


    28.9 (28.8-29.1)

    21.5 (21.4-21.7)

                *Total population = 12,882,792 ** Total population = 13,026,510

    Conclusion: Preliminary results from this multi-site prospective study indicate a substantial burden of CAP hospitalizations, especially among the very young and the very old.  As diagnostic testing is completed, etiology specific CAP incidence may provide further insight (1) into differences between the two years and (2) to help guide CAP prevention and treatment.  

    Seema Jain, MD1, Sandra R. Arnold, MD2,3, Derek J. Williams, MD, MPH4, Krow Ampofo, MD5, Wesley H. Self, MD, MPH4, Christopher Trabue, MD6, Robert Balk, MD7, Sherene Fakhran, MD, MPH8, Anna M. Bramley, MPH1, Carrie Reed, DSc, MPH1, Evan J. Anderson, MD9, Carlos G. Grijalva, MD, MPH4, Yuwei Zhu, MD, MS4, Chris Stockmann, MSc5, Robert A. Kaufman, MD3,10, Anami Patel, PhD2,3, Weston Hymas, MS, MB(ASCP)11, James D. Chappell, MD, PhD4, Chao Qi, PhD9, Mark Courtney, MD9, David Hillyard, MD5, Dean Erdman, Dr PH1, Jonas M. Winchell, PhD1, Maria Da Gloria Carvalho, PhD1, Stephen Lindstrom, PhD12, Matthew Moore, MD, MPH1, Eileen Schneider, MD, MPH1, Lauri Hicks, DO1, Andrew Pavia, MD, FIDSA, FSHEA5, Jonathan A. Mccullers, MD2,3,10, Richard G. Wunderink, MD9, Kathryn Edwards, MD, FIDSA4 and Lyn Finelli, DrPH, MS1, (1)Centers for Disease Control and Prevention, Atlanta, GA, (2)Le Bonheur Children's Hospital, Memphis, TN, (3)University of Tennessee Health Science Center, Memphis, TN, (4)Vanderbilt University School of Medicine, Nashville, TN, (5)University of Utah Health Sciences Center, Salt Lake City, UT, (6)University of Tennessee Health Sciences Center, Baptist Hospital, Nashville, TN, (7)Rush University Medical Center, Chicago, IL, (8)John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, (9)Northwestern University Feinberg School of Medicine, Chicago, IL, (10)St. Jude Children's Research Hospital, Memphis, TN, (11)Associated Regional and University Pathologists, Salt Lake City, UT, (12)Centers for Disease Control and Prevention (CDC), Atlanta, GA


    S. Jain, None

    S. R. Arnold, None

    D. J. Williams, None

    K. Ampofo, None

    W. H. Self, None

    C. Trabue, None

    R. Balk, None

    S. Fakhran, None

    A. M. Bramley, None

    C. Reed, None

    E. J. Anderson, None

    C. G. Grijalva, None

    Y. Zhu, None

    C. Stockmann, None

    R. A. Kaufman, None

    A. Patel, None

    W. Hymas, None

    J. D. Chappell, None

    C. Qi, None

    M. Courtney, None

    D. Hillyard, None

    D. Erdman, None

    J. M. Winchell, None

    M. D. G. Carvalho, None

    S. Lindstrom, None

    M. Moore, None

    E. Schneider, None

    L. Hicks, None

    A. Pavia, None

    J. A. Mccullers, None

    R. G. Wunderink, None

    K. Edwards, None

    L. Finelli, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.