{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T08:53:11Z","timestamp":1781513591491,"version":"3.54.1"},"reference-count":7,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100004331","name":"Johnson and Johnson","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004331","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2026,6]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n \n Invasive\n \n Escherichia coli<\/jats:italic>\n <\/jats:styled-content>\n disease (IED) causes significant morbidity, but little is known about its characteristics in nursing home (NH) populations.\n <\/jats:p>\n <\/jats:sec>\n \n Participants and Setting<\/jats:title>\n \n Adult long\u2010stay NH residents with electronic health record (EHR) evidence of a positive\n \n E. coli<\/jats:italic>\n <\/jats:styled-content>\n infection from Medicare\u2010certified skilled nursing facilities between 2017 and 2023 (excluding 2020\u20132021).\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This retrospective case validation study collected NH EHR data on demographics, case definition, hospitalizations, emergency visits, antibiotic use, and discharge status. Each resident's NH Minimum Data Set assessment closest to the date of qualifying\n \n E. coli<\/jats:italic>\n <\/jats:styled-content>\n culture (QEC) was also reviewed. Our IED case definition combines\n \n E. coli<\/jats:italic>\n <\/jats:styled-content>\n culture confirmation from urine or blood with clinical signs consistent with invasive disease (i.e., sepsis) within 72\u2009h.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 90 IED cases, 77.8% were female, 73.3% white, and 70% dually eligible for Medicare and Medicaid. Most cases (85.7%) were admitted from acute care facilities. Over 90% of cases were confirmed from urine specimens alone, only 7.7% from blood cultures. Sepsis was documented in 54.4% of cases, with 33.3% specifically classified as \u201csepsis due to\n \n E. coli<\/jats:italic>\n <\/jats:styled-content>\n .\u201d End\u2010organ dysfunction impacted 28% of patients, with acute kidney injury (15.6%) being most common. Over one\u2010third (36.7%) were hospitalized within 30\u2009days of diagnosis. Substantial antibiotic resistance was observed, with 61.5% of isolates resistant to ampicillin and over half resistant to fluoroquinolones. Urological risk factors included neurogenic bladder (20%) and obstructive uropathy (14%). Common comorbidities were hypertension (70%), diabetes (51.1%), and depression (47.8%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n The results of this study indicate that NH residents who develop IED incur high rates of sepsis, hospitalization, and antibiotic resistance, highlighting the importance of improved laboratory reporting systems and thorough specimen collection to enhance earlier diagnosis and treatment of\n \n E. coli<\/jats:italic>\n <\/jats:styled-content>\n infections that can progress to this life\u2010threatening disease.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jgs.70390","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T07:05:16Z","timestamp":1775027116000},"page":"1698-1702","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Invasive\n \n E. coli<\/i>\n <\/scp>\n Disease in US Nursing Homes: Brief Report of Case Validation Findings"],"prefix":"10.1111","volume":"74","author":[{"given":"H. Edward","family":"Davidson","sequence":"first","affiliation":[{"name":"Insight Therapeutics, LLC Norfolk Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9451-084X","authenticated-orcid":false,"given":"Lisa F.","family":"Han","sequence":"additional","affiliation":[{"name":"Insight Therapeutics, LLC Norfolk Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0140-539X","authenticated-orcid":false,"given":"Elizabeth A.","family":"Sillman","sequence":"additional","affiliation":[{"name":"Insight Therapeutics, LLC Norfolk Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivis","family":"Perez","sequence":"additional","affiliation":[{"name":"Insight Therapeutics, LLC Norfolk Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Bruce","family":"Simonson","sequence":"additional","affiliation":[{"name":"Johnson & Johnson Innovative Medicine Raritan New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen P.","family":"Neary","sequence":"additional","affiliation":[{"name":"Johnson & Johnson Innovative Medicine Raritan New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinne","family":"Willame","sequence":"additional","affiliation":[{"name":"Johnson & Johnson Innovative Medicine Raritan New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine C.","family":"El Khoury","sequence":"additional","affiliation":[{"name":"Johnson & Johnson Innovative Medicine Raritan New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5056-0431","authenticated-orcid":false,"given":"Kevin","family":"McConeghy","sequence":"additional","affiliation":[{"name":"Department of Health Services Policy & Practice, Brown University School of Public Health Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Gravenstein","sequence":"additional","affiliation":[{"name":"Department of Health Services Policy & Practice, Brown University School of Public Health Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2016.03.002"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2013.03.018"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2018.04.004"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad026"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879\u2010023\u201008479\u20103"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-023-00911-0"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879\u2010024\u201009669\u20103"}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.70390","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgs.70390","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.70390","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T08:03:22Z","timestamp":1781510602000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.70390"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,1]]},"references-count":7,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/jgs.70390"],"URL":"https:\/\/doi.org\/10.1111\/jgs.70390","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"value":"0002-8614","type":"print"},{"value":"1532-5415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,1]]},"assertion":[{"value":"2025-09-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}