Bacteraemia in the elderly: predictors of outcome in an urban teaching hospital

Greenberg, Benjamin; Atmar, Robert L.; Stager, Charles E.; Greenberg, Stephen B.

doi:10.1016/j.jinf.2004.06.014

Cited by 39 publications

(35 citation statements)

References 50 publications

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“…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. In a study including only nosocomial BSIs requiring ICU hospitalization, Gram positive organisms (»50%) were more common than Gram negative organisms (»40%) with Staph coagulase negative being the most common isolate.…”

Section: Microbiology Of Bsismentioning

confidence: 67%

“…13 Enterococcus spp are the causative agent in 3-10% of BSIs in most studies. 17,20,40 Anaerobes are described in 2-5% of BSIs in most studies, Polymicrobial infection in 5-15% and fungi in 0-3% in most studies, but 4-8% in nosocomial BSIs. 3,13 The incidence of candidemia is agespecific, with the maximum rates observed at the extremes of age.…”

Section: Microbiology Of Bsismentioning

confidence: 99%

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Bloodstream infections in older patients

et al. 2016

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Section: Microbiology Of Bsismentioning

confidence: 67%

Section: Microbiology Of Bsismentioning

confidence: 99%

Bloodstream infections in older patients

et al. 2016

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“…In addition, known diabetic patients with bacteremia are less likely to develop septic shock than non-diabetics (4% vs 13%, P �� 0.05), and less well to develop acute renal failure (7% vs 19%, P �� 0.05) 0.05) 0.05) [7] . The adjusted OR for mortality was 0.47 OR for mortality was 0.47 for mortality was 0.47 (0.25-0.88, , P �� 0.05) for diabetic patients when com-�� 0.05) for diabetic patients when com-0.05) for diabetic patients when com-0.05) for diabetic patients when compared to non-diabetic patients with bacteremia (21.�% vs 37.2%, P �� 0.05) [8] . However, not all studies have demonstrated a reduced mortality in diabetics with bacteremia.…”

Section: Brief Articlementioning

confidence: 92%

Diabetes patients and non-diabetic patients intensive care unit and hospital mortality risks associated with sepsis

Tayek

2012

WJD

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AIM:To compare mortality risks associated with known diabetic patients to hyperglycemic non-diabetic patients.METHODS: �ub�ed data base was searched �or pa�ub�ed data base was searched �or patients with sepsis, bacteremia, mortality and diabetes. Articles that also identi�ied new onset hyperglycemia (NOH) (�asting blood glucose > 125 mg/dL or random blood glucose > 199 mg/dL) were identi�ied and reviewed. Nine studies were evaluated with regards to hyperglycemia and hospital mortality and �ive o� the nine were summarized with regards to intensive care unit (�C�) mortality.(�C�) mortality. �C�) mortality. ) mortality. mortality. RESULTS:Historically hyperglycemia has been believed to be equally harm�ul in known diabetic patients and non-diabetics patients admitted to the hospital. �nexpectedly, having a history o� diabetes when admitted to the hospital was associated with a reduced risk o� hospital mortality. Approximately 17% o� patients admitted to hospital have NOH and 24% have diabetes mellitus. Hospital mortality was signi�icantly increased in all nine studies o� patients with NOH as compared to known diabetic patients (26.7% ± 3.4% vs 12.5% ± 3.4%, � <� �.�5�� analysis o� variance). �nad�usted �C� �.�5�� analysis o� variance). �nad�usted �C� �.�5�� analysis o� variance). �nad�usted �C� mortality was evaluated in �ive studies and was more than doubled �or those patients with NOH as compared to known diabetic patients (25.3% ± 3.3% vs 12.8% ± 2.6%, � <� �.�5) despite having similar blood glucose �.�5) despite having similar blood glucose �.�5) despite having similar blood glucose concentrations. �ost importantly, having NOH was associated with an increased �C� and a 2.7-�old increase in hospital mortality when compared to hyperglycemic diabetic patients. The mortality benefit of being diabetic is unclear but may have to do with adaptation to hyperglycemia over time. Having a history o� diabetes mellitus and prior episodes o� hyperglycemia may provide time �or the immune system to adapt to hyperglycemia and result in a reduced mortality risk. �nderstanding why diabetic patients have a lower than expected hospital mortality rate even with bacteremia or acute respiratory distress syndrome needs �urther study. CONCLUSION:Having hyperglycemia without a history o� previous diabetes mellitus is a ma�or independent risk �actor �or �C� and hospital mortality.

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“…29 There was also a strong correlation between functional score and low serum albumin level; hypoalbuminemia is a well-documented marker of morbidity and a strong predictor of mortality in elderly patients. [30][31][32] These findings indicate that it is the most severely ill, anemic, hypoalbuminemic, frail, with functional disability, nonagenarian patients who are at greatest risk of failed colonoscopy. Serum albumin level which was marginally associated with failed colonoscopy in the total cohort declined with age in our study population.…”

Section: Discussionmentioning

confidence: 91%