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Clinical Correlates of Bacteremia in a Veterans Administration Extended Care Facility
Author(s) -
Rudman Daniel,
Hontanosas Alfred,
Cohen Zev,
Mattson Dale E.
Publication year - 1988
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1988.tb07175.x
Subject(s) - bacteremia , medicine , urinary system , incidence (geometry) , mortality rate , odds ratio , streptococcus pneumoniae , confidence interval , enterococcus , population , retrospective cohort study , microbiology and biotechnology , antibiotics , physics , environmental health , optics , biology
Little is known about bacteremia in long‐term care facilities. We have conducted a retrospective study during a 12‐month period analyzing the clinical correlates of bacteremia in 533 chronically institutionalized, predominantly male patients, with an average age of 69 years. Thirty‐four men had forty‐two bacteremic illnesses during this period. The incidence rate was 0.30 episodes per WOO patient care days, and the mortality rate was 21%. The urinary tract was the most frequently identified tissue source (56%), followed by respiratory tract (7%) and skin (7%). Providencia stuartii was the most common gram‐negative organism, while Staphylococcus aureus, Streptococcus pneumoniae and enterococcus were the frequent gram‐positive microbes. Gram‐negative bacteremia accounted for 63% of the episodes (15% mortality rate), and gram‐positive bacteremia accounted for 27% (18% mortality rate); 10% of the bacteremias were polymicrobial (25% mortality rate). Most of the isolated organisms were sensitive to available antimicrobial agents. The leading risk factor for bacteremia was an indwelling urinary catheter (odds ratio 39, 95% confidence limits 16 to 97). Patients with urinary catheters at the beginning of the study constituted only 5% of the population, but accounted for 40% of the gram‐negative bacteremias during the year of observation.