Infections in the Elderly Critically-Ill Patients

Abstract

Infections are leading causes of morbidity and mortality in the advanced aged. Various factors including immunosenescens, comorbid chronic diseases, and alterations in normal physiological organ functions may modify the frequency and severity of infections in elderly patients. Normal body reactions to ensuing infection, such as increased body temperature, may be blunted in those patients causing difficulties in differential diagnosis between infection and other diseases. In severe infections the respiratory and urinary tracts are the most frequently involved systems which may be accompanied by severe sepsis. Bacteremia and sepsis are also associated with indwelling vascular catheters in the elderly who are admitted to the intensive care unit (ICU). Older patients are more vulnerable to the Clostridioides difficile infection, as well. Although the general management of infections in severely ill elderly patients is not different than in younger patients, meticulous care in fluid management and careful individualized optimization in antibiotic therapy, along with the other principals of antimicrobial stewardship are warranted in order to prevent increased mortality caused by infection. Organized team management when treating critically ill elderly patients in the ICU is essential and will reduce the morbidity and mortality due to infection in such patients.

<p>The Double Burden of the COVID-19 Pandemic and Polypharmacy on Geriatric Population – Public Health Implications</p>

“…Weaning from mechanical ventilation posed a risk of myopathy of critical illness and prolonged ICU stay due to acute lung injury, especially in patients above 70 years of age, which is a subsequent challenge. 103 On some occasions, COVID-19 patients developed sepsis, shock, septic shock, and multiple organ failure. [104][105][106] Unfortunately, the typical pathological progression in COVID-19 is still not a well-determined fact.…”

Extensive Healthy Donor Age/Gender Adjustments and Propensity Score Matching Reveal Physiology of Multiple Sclerosis through Immunophenotyping

“…Thus, we conclude that there is likely age-related decrease in immunosurveillance of CNS tissue, which may, at least partially underlie the epidemiological observations of second peak of CNS malignancies (56,57) and high morbidity of CNS infections in aged population (58,59).…”

Application of prophylactic vaccines in the elderly

“…Prevencija infektivnih bolesti u populaciji starih jeste važna mera koju treba preduzeti sa ciljem postizanja zdravog starenja i unapređenja kvaliteta života u starosti (3,6,8). Najefikasnija mera prevencije infektivnih bolesti je vakcinacija i dok se ova mera uspešno primenjuje kod dece, programi vakcinacije tokom života i vakcinacija stare populacije često su potcenjeni (8).…”