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Anales de Medicina Interna
Print version ISSN 0212-7199
Abstract
GARCIA ORDONEZ, M. A.; MOYA BENEDICTO, R.; LOPEZ GONZALEZ, J. J. and COLMENERO CASTILLO, J. D.. Epidemiological features of community and nosocomial acquired bacteremia in the hospitalized elderly patients. An. Med. Interna (Madrid) [online]. 2006, vol.23, n.2, pp.62-65. ISSN 0212-7199.
Objectives: To analyze the epidemiology and to identify associated factors for community- and nosocomial-acquired bacteremia in the elderly (BE). Patient and methods: Elderly patients diagnosed of bacteremia were selected. Community- or acquired-bacteremia were definided according to standard criteria. The severity of underlying diseases was classified as non-fatal, ultimately fatal, or rapidly fatal, according to McCabe-Jackson criteria. Multivariate analysis by logistic regression was used to identify associated factors to bacteremia. Results: Two hundred and forty-two cases of BE were selected. The mean age was 72,5 years, 50% occurred in males. One hundred and thirty cases (53,7%) were community-acquired and 112 (46,3%) cases were nosocomial-acquired BE. Most common underlying diseases were diabetes mellitus (30,6%%), chronic obstructive pulmonary disease (25,6%) and neoplasia (24%). Gram-negative bacteria were more frequently isolated in community-acquired BE, while gram-positive cocci were more common in nosocomial-acquired BE. Sources of infection were: vascular (19%), respiratory tract (18,6%), biliary tract (17,8%) and urinary tract (8,3%). The factors associated with nosocomial-acquired BE were (adjusted OR; 95%CI): underlying diseases (5,4; 2,7-10,8), neoplasia (2,5; 1,3-4,9) and vascular origin (2,2; 1,1-4,5). Fifty-two patients died (23,1%). Conclusions: BE occurs in elderly patients debilitated with well-defined underlying diseases. BE is associated to high mortality.
Keywords : Bacteremia; Epidemiology; Elderly.