A prospective study of epidemiology characteristics and outcomes of bloodstream infections in older patients

Australas J Ageing. 2021 Sep;40(3):e182-e189. doi: 10.1111/ajag.12881. Epub 2020 Nov 10.

Abstract

Objective: This study aimed to investigate the characteristics of bloodstream infections (BSIs) in older patients and describe the differences between community-acquired, hospital-acquired and health care-associated BSIs.

Methods: A prospective observational study was conducted at the University Hospital of Heraklion, Crete, Greece. Epidemiology, clinical characteristics and outcomes of BSIs were recorded.

Results: During a four-year period, 113 BSIs were recorded. Of them, 42% occurred in male patients; patients' mean age was 80 years. BSIs were community-acquired in 76% of patients, hospital-acquired in 12% and health care-associated in 12%. The most commonly isolated bacteria were E coli and K pneumoniae. Thirty-day mortality from detection of BSIs was 27%. Patients with fever, without septic shock and with appropriate empirical treatment were less likely to die.

Conclusion: Community-acquired, health care-associated and hospital-acquired BSIs had different presentation, microbiology and outcomes. Older patients had a high mortality. The absence of fever, inappropriate empirical treatment and septic shock were independent mortality predictors.

Keywords: bacteraemia; geriatrics; older; prospective.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia* / diagnosis
  • Bacteremia* / drug therapy
  • Bacteremia* / epidemiology
  • Escherichia coli
  • Humans
  • Male
  • Prospective Studies
  • Retrospective Studies
  • Sepsis* / drug therapy

Substances

  • Anti-Bacterial Agents