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Bloodstream infections in a geriatric cohort: a population-based study
Sarah J Crane1, Daniel Z Uslan, Larry M Baddour
1Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minn 55905, USA. crane.sarah@mayo.edu
The American Journal of Medicine
|December 7, 2007
Summary
Health care-associated infections pose a significant risk to the elderly, with similar mortality rates to nosocomial infections. This unique group faces a higher risk of methicillin-resistant Staphylococcus aureus.
Area of Science:
- Infectious Diseases
- Geriatric Medicine
- Epidemiology
Background:
- Health care-associated infections (HAIs) are distinct from nosocomial infections but pose risks to patients with extensive healthcare exposure.
- Elderly patients are particularly susceptible to HAIs and resistant organisms.
- Understanding the epidemiology of different infection types in geriatric populations is crucial for targeted interventions.
Purpose of the Study:
- To describe and compare the epidemiologic characteristics of community-acquired, health care-associated, and nosocomial bloodstream infections in individuals aged 65 and older.
- To identify risk factors and mortality associated with each type of bloodstream infection in the geriatric population.
Main Methods:
- A population-based, retrospective study analyzed 347 incident bloodstream infections in patients aged 65+ from Olmsted County, Minnesota (2003-2005).
- Infections were classified as community-acquired, health care-associated, or nosocomial using standardized definitions.
- Data on infection source, causative isolates, risk factors, and mortality were collected via chart review using the Rochester Epidemiology Project.
Main Results:
- Community-acquired infections accounted for 46% (159 cases), health care-associated for 44% (151 cases), and nosocomial for 10% (37 cases).
- Methicillin-resistant Staphylococcus aureus (MRSA) prevalence was high: 54% in health care-associated and 44% in nosocomial infections.
- Fourteen-day mortality was significantly higher in health care-associated (15%) and nosocomial (14%) infections compared to community-acquired (6%) infections (P=.04).
Conclusions:
- Health care-associated infections represent a distinct and vulnerable group among geriatric patients.
- This patient group exhibits an elevated risk for methicillin-resistant Staphylococcus aureus.
- Increased mortality rates are associated with health care-associated and nosocomial bloodstream infections in the elderly.
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