Solar ultraviolet-B irradiance and vitamin D may reduce the risk of septicemia

Figures & data

Table 1 Characteristics of septicemia epidemiology in the united states

Feature	Finding	Reference
Seasonality	Peak in winter, 17.7% higher in winter than in fall	9
	40% increase in septicemia linked to respiratory infections in winter compared with that in fall	9
Geographic variation	Highest rate in the Northeast, lowest in West	9
Trends	Incidence rates were relatively constant from 1979 to 1982 (20 cases/100,000/year), then doubled by 1985 and rose by another 20 cases/100,000/year in the mid-1990s	9
Racial disparity	Lowest hospitalization rates for whites, higher for African Americans and other races in the United States	5, 10, 11
Sex	For 1979–2001, males made up 53.2% of cases of septicemia with cancer but only 47.9% of septicemia without cancer	5
Age dependence	Death rate increases with age (RR per decile, 1.32 [95% CI, 1.31–1.34])	10
Comorbidity, death rates	Cancers (RR, 2.15 [95% CI, 2.04–2.26])	10
	HIV (RR, 2.40 [95% CI, 2.10–2.73])	10
	Pulmonary infection (RR, 1.66 [95% CI, 1.58–1.74])	10
	Cirrhosis (RR = 1.59 [95% CI, 1.42–1.77])	10
	Congestive heart failure (RR, 1.38 [95% CI, 1.31–1.45])	10
	(HR = 3.38 [95% CI, 2.67–4.29])	12
	Peripheral vascular disease (HR = 1.96 [95% CI, 1.53–2.53])	12
	COPD (HR = 1.64 (95% CI, 1.22–2.19])	12
	Diabetes (OR = 4.6 [95% CI, 1.2–18.1]; p = 0.03)	13
High body mass index	Increased risk for death for those with bacteriemia.	14
Sex differences	Males have about a 20% higher incidence rate than females in the United States	5
Urban/rural	Higher in urban regions, lower in rural regions	11

CI, confidence interval; COPD, chronic obstructive pulmonary disease; HR, hazard ratio; RR, relative risk.

Table 2 Regional and seasonal variation of septicemia incidence rates in the united states, 1979–2003a

Region	Winter	Spring	Summer	Fall	Winter/Fall
Northeast	65	57	55	50	1.30
Midwest	53	47	47	47	1.14
South	47	49	47	44	1.08
West	42	39	38	36	1.16
NE/W	1.55	1.46	1.44	1.39

a Data are cases/100,000/year.

Table 3 Incidence of septicemia among patients with cancer, 1979–200110

Cancer	Male/female (risk ratio, 95% CI)	African American/white (risk ratio, 95% CI)	Smoking as a risk factor	Vitamin D as a risk factor
Lung	1.17 (1.10–1.23)	1.28 (1.16–1.40)	Yes	Yes
Gastrointestinal	0.84 (0.73–0.94)	1.24 (0.90–1.58)	No	Yes
Urinary tract	0.74 (0.58–0.91)	1.70 (0.97–2.42)	Yes	Yes
Leukemia	0.89 (0.76–1.03)	2.94 (2.11–3.77)	No	No
Lymphoma	1.13 (0.98–1.27)	1.28 (0.98–1.58)	No	No
Breast		2.28 (1.10–3.47)	No	Yes
Prostate		1.25 (0.84–1.65)	No	Yes
Female reproductive tract		1.68 (1.08–2.28)	-a	Yes

CI, confidence interval.

a Cervical cancer, yes; endometrial and ovarian cancer, no.

Danai PA, Sinha S, Moss M, Haber MJ, Martin GS. Seasonal variation in the epidemiology of sepsis. Crit Care Med 2007; 35:410 - 415

 PubMed Web of Science ®Google Scholar

Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 2003; 348:1546 - 1554

 PubMed Web of Science ®Google Scholar

Danai PA, Moss M, Mannino DM, Martin GS. The epidemiology of sepsis in patients with malignancy. Chest 2006; 129:1432 - 1440

 PubMed Web of Science ®Google Scholar

Barnato AE, Alexander SL, Linde-Zwirble WT, Angus DC. Racial variation in the incidence, care and outcomes of severe sepsis: Analysis of population, patient and hospital characteristics. Am J Respir Crit Care Med 2008; 177:279 - 284

 PubMed Web of Science ®Google Scholar

Olsen MA, Krauss M, Agniel D, Schootman M, Gentry CN, Yan Y, et al. Mortality associated with bloodstream infection after coronary artery bypass surgery. Clin Infect Dis 2008; 46:1537 - 1546

 PubMed Web of Science ®Google Scholar

Sreeramoju PV, Tolentino J, Garcia-Houchins S, Weber SG. Predictive factors for the development of central line-associated bloodstream infection due to gram-negative bacteria in intensive care unit patients after surgery. Infect Control Hosp Epidemiol 2008; 29:51 - 56

 PubMed Web of Science ®Google Scholar

Huttunen R, Laine J, Lumio J, Vuento R, Syrjänen J. Obesity and smoking are factors associated with poor prognosis in patients with bacteraemia. BMC Infect Dis 2007; 7:13

 PubMed Web of Science ®Google Scholar