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Community‐Acquired Bacteremia in the Elderly: A Prospective Study of 121 Cases
Author(s) -
Whitelaw David A.,
Rayner Brian L.,
Willcox Paul A.
Publication year - 1992
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.1532-5415.1992.tb04475.x
Subject(s) - medicine , bacteremia , prospective cohort study , klebsiella pneumoniae , confusion , mortality rate , antibiotics , pediatrics , microbiology and biotechnology , psychoanalysis , biology , psychology , biochemistry , chemistry , escherichia coli , gene
Objective : To describe community‐acquired bacteremia in the elderly and correlate clinical and laboratory findings with outcome. Design : Prospective study of consecutive cases. Setting : Large community‐based teaching hospital. Patients : One hundred and twenty‐one elderly patients aged 65 to 89 years, seen between February 1, 1986 and January 31, 1988. Main Outcome Measures : Bacteriological cultures, symptoms and signs, laboratory findings, and mortality. Results : Gram‐negative organisms accounted for 65 (54%) cases and Gram‐positive organisms for 47 (39%) cases, while nine (7%) cases were polymicrobial. E. coli (39%), Klebsiella sp. (8%), S. pneumoniae (14%), and S. aureus (12%) were the most commonly isolated organisms. The overall mortality was 38%. A poor prognosis was associated with confusion as a presenting symptom ( P < 0.0003), hypotension ( P < 0.0003), and inappropriate or delayed treatment ( P < 0.02). A good prognosis was associated with E. coli as the pathogen ( P < 0.0003) and prompt, appropriate antibiotic therapy. Conclusion : Community‐acquired bacteremia in the elderly has a high mortality rate. Early recognition and prompt, appropriate treatment are critical in reducing the mortality. J Am Geriatr Soc 40:996–1000, 1992