Community‐Acquired Bacteremia in the Elderly: Analysis of One Hundred Consecutive Episodes

Abstract

A retrospective analysis was made of the records of 100 consecutive geriatric patients with community-acquired bacteremia, admitted to a suburban hospital. The most frequently identified tissue sources for these bacteremias were the urinary tract (34 percent), biliary tract (20 percent), and lungs (13 percent). In 11 percent of the patients, the tissue focus was not established. E. coli, Klebsiella species and Streptococcus pneumoniae were the most common organisms isolated, and they contributed to 73 percent of the bacteremias. Of the 100 patients, 26 succumbed to the infection. Clinical manifestations unique to the geriatric patient are described.

Risk Factors for Death in Elderly Emergency Department Patients with Suspected Infection

“…Consideration of these risk factors allows an ED physician to stratify elderly people with infection into those at low and high risk for mortality and thus provide the most appropriate care for high-risk elderly people. Such information should be particularly valuable to ED physicians because mortality in elderly people with severe infection is high, 5,8 with rates ranging from 21% to 37% for bacteremia, [24][25][26][27][28][29] ranging from 10% to 53% for pneumonia, 17,[30][31][32] and of 6% for urinary tract infection. 33 The difficulty in identifying a high-risk subpopulation among these patients demonstrates the need to identify such independent risk factors for death in geriatric patients with infection.…”

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

“…[1][2][3][4][5][6][7][8][9][10][11] Scoring systems have been devised using all patients with bacteraemia as a cohort and then identifying important prognostic factors among the individuals. Several studies have identified age as an independent predictor of mortality in patients with sepsis.…”

Unique Aspects of Urinary Tract Infection in the Geriatric Population

“…Some of these manifestations may be second ary to bacteremia or urosepsis. Although no direct comparisons have been made, there are data suggesting UTI in the elderly has a greater incidence of bacteremia than younger patients [ 12,13], Several studies confirm that UTI is the most common cause of bactercmic sepsis in the elderly [6,26]. Hence, the pres ence or absence of typical genitourinary man ifestations of bacteriuria are unreliable pa rameters in diagnosing or excluding UTI in the elderly.…”

“…The most com mon cause of sepsis in the elderly is urinary tract infection (UTI) [6,26]. Moreover, gram-negative sepsis in the geriatric age group is associated with a mortality rate ex ceeding 50% [15].…”