Bloodstream Infection: Differences Between Young‐Old, Old, and Old‐Old Patients

Gavazzi, G.; Mallaret, Marie-Reine; Couturier, Pascal; Iffenecker, Anne; Franco, A

doi:10.1046/j.1532-5415.2002.50458.x

Cited by 62 publications

(56 citation statements)

References 33 publications

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“…37 Even in the absence of an indwelling urinary catheter, higher rates of UTI in older patients may be secondary to incontinence or neurological disorders and to a higher rate of bacteremia associated with pyelonephritis in older people. 30,35,38 As presented in Table 3, most studies reported respiratory tract as the source in 9-28% of patients. An abdominal source was reported in 1-20%, depending whether a biliary source was included in the definition or not.…”

Section: Source Of Bsismentioning

confidence: 99%

“…In studies including only community acquired infections, Gram negative bacteria represent up to 70% of BSIs, 20 in contrast to studies including only nosocomial BSI, in which Gram negative bacteria constitute 40-50% 3,13 but are still more common than Gram positive organisms. 41 Gram positive organisms usually represent between 30-45% of BSIs in elderly, 20,28,35 although some studies reported 55-60%. 29,40 In these studies, however, rates of methicillin resistance Staph aureus (MRSA) infection were higher compared to other studies in mixed population of community acquired and nosocomial BSIs.…”

Section: Microbiology Of Bsismentioning

confidence: 99%

“…60 Factors contributing to this difference include senescence of both humoral and cell-mediated immune systems; reduced physiologic reserve capacity; increased incidence of underlying illnesses; poor tolerance to invasive diagnostic and therapeutic procedures; greater risk and incidence of nosocomial infections; and higher rates of adverse reactions to drugs, including antibiotics. 4,28 Predictors of mortality in elderly in most studies include increasingage, 3,8,11,13,14,20,22,28,29,33,47,61 noncommunityacquisition, 11,14,28,61,62 poor functional status, 3,11,61,63,64 comorbidities, 14,22,29,33,47 respiratory, 13 35 Enterococcus spp. 14 S. pneumonia, 22 and Enterobacteriaceaeresistantto3rdgenerationcephalosporins 14 werealso associatedwithincreasedmortality.E.coliwasdemonstratedto beprotectiveinonestudy.…”

Section: Mortalitymentioning

confidence: 99%

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Bloodstream infections in older patients

et al. 2016

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Section: Source Of Bsismentioning

confidence: 99%

Section: Microbiology Of Bsismentioning

confidence: 99%

Section: Mortalitymentioning

confidence: 99%

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Bloodstream infections in older patients

et al. 2016

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“…Moreover, dementia, instability of gait, falls, and swallowing disorders also increase with age. These conditions add to morbidity and higher mortality from infectious diseases [5,[26][27][28][29]. Lastly, there are specific communal challenges that occur in infections in the elderly.…”

Section: An Overview Of Infections In the Elderly And Ltcfsmentioning

confidence: 99%

Taking stock of infections and antibiotic resistance in the elderly and long-term care facilities: A survey of existingand upcoming challenges

Augustine¹

2011

European Journal of Microbiology and Immunology

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Treating elderly patients with infections represents one of the greatest challenges to health-care providers. Older adults are the largest growing sector of the population and suffer excessively from infectious diseases such as pneumonia, urinary tract infections (UTIs), and skin and soft-tissue infections. Often because of disabilities, the elderly require treatment of infectious diseases in long-term care facilities (LTCFs). As a result of antibiotic use, LTCFs have become "reservoirs of resistance" and multi-drug resistant (MDR) pathogens are frequently recovered. Clinicians also need to be aware of the impairment of immune function and other emerging chronic infections (HIV, HCV) that are now present in the elderly. Despite vigilance regarding this issue, delays in diagnosis and initiation of therapy are common. This article reviews the changing landscape of infections in the elderly and the challenge these syndromes present in the context of an increasing older population that requires dedicated resources.

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“…[1][2][3][4] Staphylococcus aureus bloodstream infection (SAB) represents a significant burden in terms of morbidity and mortality for older adults. Major risk factors associated with the development of SAB includes the presence of comorbid illnesses, such as congestive heart failure, chronic kidney disease, and diabetes mellitus, and the use of medical devices.…”

mentioning

confidence: 99%

Staphylococcus aureus Bloodstream Infections in Older Adults: Clinical Outcomes and Risk Factors for In‐Hospital Mortality

Big¹,

Malani²

2010

J American Geriatrics Society

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OBJECTIVES:To assess clinical outcomes and identify risk factors for mortality in older adults with Staphylococcus aureus bloodstream infection (SAB). DESIGN: Retrospective review. SETTING: University of Michigan Health System, Ann Arbor. PARTICIPANTS: All patients aged 80 and older with SAB between January 2004 and July 2008. MEASUREMENTS: Clinical data, including comorbid conditions, SAB source, echocardiography results, Charlson Comorbidity Index, mortality (in-hospital and 6-month), and need for rehospitalization or chronic care after discharge. RESULTS: Seventy-six patients aged 80 and older (mean 85.5 AE 4.2) with SAB were identified. Infection sources included 14 (18.4%) vascular catheter associated, 16 (21.1%) wound related, seven (9.2%) endocarditis, five (6.6%) intravascular, and 19 (25%) with unknown source; 46 (60.5%) patients had methicillin-resistant strains. Twentytwo (28.9%) patients underwent surgery or device placement within 30 days of developing SAB; 10 of these 22 had SAB associated with surgical site infection (SSI). Twenty two (28.9%) patients died in the hospital or were discharged to hospice care; at least 43 (56.6%) patients died within 6 months of presentation, and eight were lost to follow-up. Unknown source of bacteremia (odds ratio 5 5.2, P 5.008) was independently associated with in-hospital death. Echocardiography was not pursued in 45% of patients. Of surviving patients, 40 (74.1%) required skilled care after discharge; eight (20%) required rehospitalization. CONCLUSION: SAB was associated with high mortality rates in patients aged 80 and older. The observed association between SAB and SSI may direct preventive strategies such as perioperative decolonization or antimicrobial prophylaxis. Interventions to optimize clinical care practices in elderly patients with SAB are essential given the associated morbidity and mortality. J Am Geriatr Soc 58:300-305, 2010.

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Bloodstream Infection: Differences Between Young‐Old, Old, and Old‐Old Patients

Cited by 62 publications

References 33 publications

Bloodstream infections in older patients

Bloodstream infections in older patients

Taking stock of infections and antibiotic resistance in the elderly and long-term care facilities: A survey of existingand upcoming challenges

Staphylococcus aureus Bloodstream Infections in Older Adults: Clinical Outcomes and Risk Factors for In‐Hospital Mortality

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