Community acquired infections in elderly population

• Autorzy: Yasar Kucukardali , Oral Oncul , Erdogan Kunter , Vedat Turhan , Emrullah Solmazgul , Hakan Terekeci , Ozkan Sayan , Cagatay Oktenli
• Języki publikacji: EN

Abstrakty

EN

In geriatric practice, data regarding infections including the epidemiology, morbidity, and mortality are lacking. Our aim was to evaluate the frequency, location, microbiological and laboratory characteristics of infectious diseases in elderly population admitted to a training hospital. The patients were included total of 330 patients, aged over 65 with infection, seen between January 1, 2005 and January 1, 2006. In the result, of patients 136 (41%) had respiratory system infection, 90 (27%) urinary system infection, 39 (12%) gastrointestinal system infection, 34 (10%) bloodstream infections, 17 (5%) soft tissue infection, 8 (2%) central nervous system infections, and 6 (2%) others. Average length of hospitalization was 8.6±7.7 days. Mortality rate from all causes was 57 (17%). The most common infections in elderly patients were respiratory tract and urinary system infections, and there were no fever, leukocytes and high CRP levels in approximately 1/3 of cases. Infectious diseases may occur even in the absence of such infection indicators as fever, raised WBC count and high CRP level in the elderly population.

Słowa kluczowe

EN

Elderly; Fever; Infection; C-reactive protein; Leukocyte

• Czasopismo: Open Medicine
• Rocznik: 2009
• Tom: 4
• Numer: 2
• Strony: 171-178

Daty

wydano

2009-06-01

online

2009-03-27

Twórcy

autor

Yasar Kucukardali

• Division of Internal Medicine, GATA Haydarpasa Training Hospital, Tibbiye Caddesi, TR-34668, Kadikoy-Istanbul, Turkey,

autor

Oral Oncul

• Department of Infectious Diseases and Clinical Microbiology, GATA Haydarpasa Training Hospital, Tibbiye Caddesi, TR-34668, Kadikoy-Istanbul, Turkey

autor

Erdogan Kunter

• Department of Respiratory Diseases and Tuberculosis, GATA Haydarpasa Training Hospital, Tibbiye Caddesi, TR-34668, Kadikoy-Istanbul, Turkey

autor

Vedat Turhan

• Department of Infectious Diseases and Clinical Microbiology, GATA Haydarpasa Training Hospital, Tibbiye Caddesi, TR-34668, Kadikoy-Istanbul, Turkey

autor

Emrullah Solmazgul

• Division of Internal Medicine, GATA Haydarpasa Training Hospital, Tibbiye Caddesi, TR-34668, Kadikoy-Istanbul, Turkey

autor

Hakan Terekeci

• Division of Internal Medicine, GATA Haydarpasa Training Hospital, Tibbiye Caddesi, TR-34668, Kadikoy-Istanbul, Turkey

autor

Ozkan Sayan

• Division of Hematology, GATA Haydarpasa Training Hospital, Tibbiye Caddesi, TR-34668, Kadikoy-Istanbul, Turkey

autor

Cagatay Oktenli

• Division of Internal Medicine, GATA Haydarpasa Training Hospital, Tibbiye Caddesi, TR-34668, Kadikoy-Istanbul, Turkey

Bibliografia

• [1] Valenti W.M., Trudell R.G., Bentley D.W., Factors predisposing to oropharyngeal colonisation with gram-negative bacilli in the aged. N. Engl. J. Med., 1978, 298, 1108–1111
• [2] Irwin R.S., Whitaker S., Pratter M.R., et al., The transiency of oropharyngeal colonization with gramnegative bacilli in resident of skilled nursing facility. Chest, 1982, 81, 31–35 http://dx.doi.org/10.1378/chest.81.1.31[Crossref]
• [3] Chassagne P., Bentot-Levasseur C., Druesne L., Bercoff E., Doucet J., Respiratory tract infections in the elderly living in institutions: prevention. Rev.Mal. Respir., 2002, 19, 627–632.
• [4] Lim K.H., Yap K.B., The presentation of elderly people at an emergency department in Singapore. Singapore Med. J., 1999, 40, 742–744
• [5] Avkan-Oguz V., Yapar N., Erdenizmenli M., et al., Effects of community-acquired infections on fever, leukocyte count and the length of stay in elderly. A cross-sectional study of 240 cases. Saudi Med. J., 2006, 27, 368–372
• [6] Lionel A. Mandell, Richard G. Wunderink, Antonio Anzueto, John G. Bartlett, G. Douglas Campbell, Nathan C. Dean, Scott F. Dowell, Thomas M. File, Daniel M. Musher, Michael S. Niederman, Antonio Torres, Cynthia G. Whitney, Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults. Clinical Infectious Diseases 2007; 44:S27–72. http://dx.doi.org/10.1086/511159[Crossref]
• [7] Hooton TM, Stamm WE. Diagnosis and treatment of uncomplicated urinary tract infection. Infect Dis Clin North Am. 1997, 11: 551–581 http://dx.doi.org/10.1016/S0891-5520(05)70373-1[Crossref]
• [8] Sobel JD, Kaye D. Urinary Tract Infection, in Mandell, Douglas, and Bennetts Principles and Practica of Infectious Diseases, Eds, Mandell GL, Bennett JE, Dolin R. Sixth Edition, Elsevier Churchill Livingstone, p: 875–905, 2005.
• [9] Munford RS. Sepsis, Severe Sepsis, and Septic Shock. in Mandell, Douglas, and Bennetts Principles and Practica of Infectious Diseases, Eds, Mandell GL, Bennett JE, Dolin R. Sixth Edition, Elsevier Churchill Livingstone, p: 906–926, 2005.
• [10] Overturf GD. Defining bacterial meningitis and other infections of the central nervous system [Definitions of Specific Infections. Pediatric Clinical Care Medicine, 2005, 6 (3), Supplement May, 14–18. http://dx.doi.org/10.1097/01.PCC.0000161933.42822.86[Crossref]
• [11] Koneman EW, Allen SD, Janda WM, Schreckenberger PC, Winn Jr WC. The enterobacteriaceae. Color Atlas and Textbook of Diagnostic Microbiology. 5th edition, Lippincott, Philadelphia, 1997.
• [12] Wayne PA. National Committee for Clinical Laboratory Standarts: Performance standarts for antimicrobial susceptibility testing. NCCLS Document M100-S13 (M2 A8), USA, 2003.
• [13] Ames SG. The success of plasmid-encoded resistance genes in clinhical bacteria. An examination of plasmid-mediated ampicillin and trimethoprim resistance genes and their resistance mechanisms, J Med Microbiol, 1989; 28: 73–78. [Crossref]
• [14] Sugakoff W, Jarlier V. Comparative potency oüf mecilinam and other beta-lactam antibiotics against Escherichia coli strains producing different beta-lactamases. J Antimicrob Chemother. 2000, 46: Suppl 1. 9–14. http://dx.doi.org/10.1093/jac/46.suppl_1.9[Crossref]
• [15] M. Kompoti, S. Drimis, A. Papadaki, K. Kotsomytis, C. Poulopoulou, D. Gianneli, D. Voutsinas Serum C-reactive protein at admission predicts in-hospital mortality in medical patients. European Journal of Internal Medicine, 2008,. 19 (4), 261–265 http://dx.doi.org/10.1016/j.ejim.2007.06.016[Crossref]
• [16] Mouton C.P., Bazaldua O.V., Pierce B., Espino D.V., Common infections in older adults. Am. Fam. Physician, 2001, 63, 257–268
• [17] Chandra R.K. Nutritional regulation of immunity and risk of infection in old age. Immunology, 1989, 67, 141–147
• [18] Fletcher J.P., Little J.M., Walker P.J., Anergy and the severely ill surgical patient. Aust.N.Z.J.Surg., 1986, 56, 117–120 http://dx.doi.org/10.1111/j.1445-2197.1986.tb01866.x[Crossref]
• [19] Pavie G.J., Prida C.J.M., Diaz F.A., Saldias P.F., Assessment of the management of communityacquired pneumonia in adult outpatients. Rev. Med. Chil., 2005, 133, 1322–1330
• [20] Tamang M.D., Dey S., Makaju R.K., et al., Prevalence of Moraxella catarrhalis infections of the lower respiratory tract in elderly patients. Kathmandu Univ. Med. J. 2005, 3, 39–44
• [21] Yen M.Y., Hu B.S., Chen Y.S., et al., A prospective etiologic study of community-acquired pneumonia in Taiwan. J. Formos. Med. Assoc., 2005, 104, 724–730
• [22] Leung W.S., Chu C.M., Tsang K.Y., et al., Fulminant community-acquired Acinetobacter baumannii pneumonia as a distinct clinical syndrome. Chest, 2006, 129, 102–109 http://dx.doi.org/10.1378/chest.129.1.102[Crossref]
• [23] Niederman M.S., Bass J.B. Jr., Campbell G.D., et al., Guidelines for the initial management of adults with community-acquired pneumonia: diagnosis, assessment of severity, and initial antimicrobial therapy. American Thoracic Society. Medical Section of the American Lung Association. Am. Rev. Respir. Dis., 1993, 148, 1418–1426
• [24] Marrie T.J., Clinical strategies for managing pneumonia in-the elderly. Clin. Geriatrics Suppl., 1999, 1, 6–10
• [25] Yoshikawa T.T., Ambulatory management of common infections in elderly patients. Infect. Med., 1991, 20, 37–43
• [26] Zhanel G.G., Harding G.K., Guay D.R., Asymptomatic bacteriuria. Which patients should be treated? Arch. Intern. Med., 1990, 150, 1389–1396 http://dx.doi.org/10.1001/archinte.150.7.1389[Crossref]
• [27] Kumamoto Y., Tsukamoto T., Matsukawa M., et al., Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections. Japon J. Antibiot., 2005, 58, 544–556
• [28] Nys S., van Merode T., Bartelds A.I., Stobberingh E.E., Antibiotic treatment and resistance of unselected uropathogens in the elderly. Int. J. Antimicrob. Agents, 2006, 27, 236–241 http://dx.doi.org/10.1016/j.ijantimicag.2005.10.015[Crossref]
• [29] Bonadio M, Costarelli S, Morelli G, Tartaglia T. The influence of diabetes mellitus on the spectrum of uropathogens and the antimicrobial resistance in elderly adult patients with urinary tract infection. BMC Infect Dis. 2006, 17;6:54. http://dx.doi.org/10.1186/1471-2334-6-54[Crossref]
• [30] Haber N., Paute J., Gouot A., et al., Incidence and clinical characteristics of symptomatic urinary infections in a geriatric hospital. Med. Mal. Infect., 2007, 37, 664–672. [WoS]
• [31] Gavazzi G., Mallaret M.R., Couturier P., Iffenecker A., Franco A., Bloodstream infection: differences between young-old, old, and old-old patients. J. Am. Geriatr. Soc. 2002, 50, 1667–1673 http://dx.doi.org/10.1046/j.1532-5415.2002.50458.x[Crossref]
• [32] Scheinfeld N., Infections in the elderly. Dermatol. Online J., 2005, 11, 8
• [33] Joshi N., Caputo G.M., Weitecamp M.R., Karchmer A.W., Infections in patients with diabetes mellitus. N. Eng. J. Med., 1999, 341, 1906–1912 http://dx.doi.org/10.1056/NEJM199912163412507[Crossref]
• [34] Rahman S.H., Larvin M., McMahon M.J., Thompson D., Clinical presentation and delayed treatment of cholangitis in older people. Dig. Dis. Sci., 2005, 50, 2207–2210 http://dx.doi.org/10.1007/s10620-005-3035-5[Crossref]
• [35] Chantri Trinh, Kavita Prabhakar. Diarrheal Diseases in the Elderly. Clinics in Geriatric Medicine, 2007, 23 (4), 833–856 http://dx.doi.org/10.1016/j.cger.2007.06.005[WoS][Crossref]
• [36] Pinner R.W., Teutsch S.M., Simonsen L., et al. Trends in infectious diseases mortality in the United States. J.A.M.A., 1996, 275, 189–193 http://dx.doi.org/10.1001/jama.275.3.189[Crossref]
• [37] Harper C., Newton P., Clinical aspects of pneumonia in the elderly veteran. J. Am. Geriatr. Soc. 1989, 37, 867–872 [Crossref]

Identyfikatory

DOI

10.2478/s11536-008-0072-4