title: Hospitalizations due to selected infections caused by opportunistic premise plumbing pathogens (OPPP) and reported drug resistance in the United States older adult population in 1991-2006.
abstract: The Flint Water Crisis-due to changes of water source and treatment procedures-has revealed many unsolved social, environmental, and public health problems for US drinking water, including opportunistic premise plumbing pathogens (OPPP). The true health impact of OPPP, especially in vulnerable populations such as the elderly, is largely unknown. We explored 108claims in the largest US national uniformly collected data repository to determine rates and costs of OPPP-related hospitalizations. In 1991-2006, 617,291 cases of three selected OPPP infections resulted in the elderly alone of $0.6 billion USD per year of payments. Antibiotic resistance significantly increased OPPP illness costs that are likely to be underreported. More precise estimates for OPPP burdens could be obtained if better clinical, microbiological, administrative, and environmental monitoring data were cross-linked. An urgent dialog across governmental and disciplinary divides, and studies on preventing OPPP through drinking water exposure, are warranted.
authors.affiliation: Tufts University Friedman School of Nutrition Science and Policy, 150 Harrison Avenue, Jagaris-250, Boston, MA, 02111, USA. elena.naumova@tufts.edu.|Tufts University School of Engineering, Medford, USA. elena.naumova@tufts.edu.|Tufts University School of Medicine, Boston, USA. elena.naumova@tufts.edu.
authors.forename: Elena N
authors.initials: EN
authors.lastname: Naumova
authors.affiliation: Tufts University School of Engineering, Medford, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Liss
authors.affiliation: University of Illinois at Chicago, Chicago, USA.
authors.forename: Jyotsna S
authors.initials: JS
authors.lastname: Jagai
authors.affiliation: Mt. Auburn Hospital, Cambridge, MA, USA.
authors.forename: Irmgard
authors.initials: I
authors.lastname: Behlau
authors.affiliation: Tufts University Friedman School of Nutrition Science and Policy, 150 Harrison Avenue, Jagaris-250, Boston, MA, 02111, USA.|Tufts University School of Engineering, Medford, USA.|Tufts University School of Medicine, Boston, USA.
authors.forename: Jeffrey K
authors.initials: JK
authors.lastname: Griffiths
mesh_terms: D000368:Aged; D024881:Drug Resistance, Bacterial; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016952:Legionella pneumophila / Q000187:drug effects; D007877:Legionnaires' Disease / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D015269:Mycobacterium avium Complex / Q000187:drug effects; D015270:Mycobacterium avium-intracellulare Infection / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D012498:Sanitary Engineering; D014481:United States; D014881:Water Supply / Q000592:standards; D000069578:Waterborne Diseases / Q000188:drug therapy* / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology
keywords: US Centers for Medicare and Medicaid Services; drug resistance; hospitalization; older adults; opportunistic premise plumbing pathogens