Bacteriemias en Mayores de 65 años
Objectives: To evaluate clinical and bacteriological parameters and morbimortality in patients older than 65 years old with bacteremia (Group A), and to compare with patients younger than 65 years old (Group B), hospitalized in an Internal Medicine Service.- Material and Methods: In a protocoliz...
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| Publicado en: | Revista Médica Universitaria |
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| Autores principales: | , , , , , , |
| Materias: | |
| Acceso en línea: | https://bdigital.uncu.edu.ar/fichas.php?idobjeto=2745 |
| Sumario: | Objectives: To evaluate clinical and bacteriological parameters and
morbimortality in patients older than 65 years old with bacteremia (Group A), and
to compare with patients younger than 65 years old (Group B), hospitalized in an
Internal Medicine Service.-
Material and Methods: In a protocolized, descriptive and observational study
from year 1989 through 2006 we studied patients with two or more positive blood
cultures. Data was analized with Epi Info 6.4.
Results: 668 bacteremias were identified: 258 (38.6%) in A and 410 (61.4%) in
B. The mean age was 74.2 years (SD+7.01) and 47.2 years (SD+13.7)
respectively. There were no differences in the mean hospital stay: 19.1
(SD+17.07) in A vs 19.9 days (SD+18.1) in B, neither in nosocomial acquisition
(10.7 vs 44%). The pulmonary (31 vs 21.2%)(p<0.008) and urinary source (27 vs
18.8%)(p=0.017), arterial hypotension (40.8 vs 32.2%)(p=0.03), olyguria (41.7 vs
30.9%)(p=0.005) and encephalopathy (54.5 vs 39.4%)(p=0.00014) were more
frequent in A. Fever >38°C was more common in B (9 0.9 vs 83.8%)(p=0.0068).
Gram negative bacilli bacteremia were most common in A (46 vs 37%)(p>0.01).
mainly with A. baumani (9.16 vs 4.6%) and E. coli (54.1 vs 42.7%)(p>0.05), and
in B was S. aureus (39.39 vs 24.63)(p=0.01). There were no diferences between
S. pneumoniae bacteremia:13.17 in A and 15.36% in B. Septic shock (33.9 vs
22.4%) and new organ failures (31.1 vs 20.1%) occurred mainly in A (p>0.001).
In hospital mortality was 34.49% in A and 23.41% in B (p=0.018).
Conclusions: Bacteremias in elderly hospitalized patients compared to those
occurred in younger patients were significantly characterized by predominance of
pulmonary and urinary source; arterial hypotension, olyguria and encephalopathy;
gram negative bacilli bacteremia, mainly A. baumani and E. coli; more frequent
development of septic shock; less frequency of fever>38°C and S.Aureus
bacteremia and to significantly higher mortality.
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