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Bloodstream infection: differences between young-old, old, and old-old patients
Gaetan Gavazzi1, Marie-Reine Mallaret, Pascal Couturier
1Department of Geriatrics and Community Medicine, Department of Hygiene, and Center Hospitalier Universitaire, Albert Michallon, Grenoble, France. Gaetan.Gavazzi@hcuge.ch
Journal of the American Geriatrics Society
|October 9, 2002
Summary
Older adults aged over 85 experienced more community-acquired bloodstream infections (BSI), with differing pathogens compared to younger elderly groups. Mortality was linked to methicillin-resistant Staphylococcus aureus in both community-acquired and nosocomial BSIs.
Area of Science:
- Geriatric Medicine
- Infectious Diseases
- Epidemiology
Background:
- Bloodstream infections (BSI) pose significant risks to elderly populations.
- Understanding age-related differences in BSI characteristics is crucial for effective treatment.
Purpose of the Study:
- To compare epidemiological and microbiological features of BSI across three elderly age groups: young-old (65-75), old (76-85), and old-old (>85).
Main Methods:
- Retrospective study involving 1,740 patients aged 65+ with BSI.
- Data collected from 46 hospitals in southeast France between January 1 and December 31, 1998.
- Analysis of epidemiological, microbiological, and outcome data.
Main Results:
- Community-acquired BSIs (CABSIs) were more frequent in the old-old group.
- Nosocomial BSIs (NSBIs) showed significant microbiological differences across age groups.
- Escherichia coli was the primary pathogen in the old-old, while Staphylococcus aureus predominated in the young-old.
- Mortality was independently associated with methicillin-resistant S. aureus in both NSBI and CABSI.
Conclusions:
- Age influences BSI characteristics, particularly for CABSIs, highlighting the vulnerability of the oldest old.
- Differences in NSBI pathogens necessitate tailored empirical antibiotic strategies.
- Further prospective research is recommended to explore predisposing factors in this frail population.