Bloodstream infections in patients older than eighty years

Area of Science:

• Geriatrics
• Infectious Diseases
• Internal Medicine

Background:

• Bacteraemia presents unique challenges in elderly populations.
• Understanding risk factors and outcomes in older adults is crucial for effective healthcare.

Purpose of the Study:

• To compare bacteraemia episodes in patients aged 80+ versus 60-79.
• To identify sources, characteristics, and fatality factors of bacteraemia in these age groups.

Main Methods:

• Retrospective analysis of 339 bacteraemia episodes in patients 80+ and 658 in patients 60-79.
• Comparison of demographics, infection sources, acquired location, and pathogens.
• Analysis of factors associated with in-hospital fatality.

Main Results:

• Patients 80+ had higher rates of nursing home residency and cerebrovascular accident history.
• Hospital-acquired bacteraemia was less common in the 80+ group (24% vs 40%).
• Urinary tract infections were the most frequent source in both groups, particularly in the 80+ group (50%).
• Anaerobic bacteria were more prevalent in the 80+ group (5% vs 1%).
• In-hospital fatality was 35% in the 80+ group and 30% in the 60-79 group.
• Fatality was not directly associated with advanced age but with hospital-acquired infection, shock, low serum albumin, renal dysfunction, and inappropriate antibiotic treatment.

Conclusions:

• Bacteraemia in the very elderly has distinct characteristics compared to the 'younger' elderly.
• Effective management requires addressing hospital-acquired infections, prompt diagnosis, and appropriate antibiotic therapy.
• Factors beyond chronological age significantly influence outcomes in elderly patients with bacteraemia.