Clinical outcomes and epidemiological characteristics of bacteremia in the older Japanese population

被引:3
|
作者
Nakamura, Keiji [1 ,2 ,6 ]
Hayakawa, Kayoko [1 ,3 ]
Tsuzuki, Shinya [1 ,3 ,4 ]
Ide, Satoshi [1 ,5 ]
Nomoto, Hidetoshi [1 ,5 ]
Nakamoto, Takato [1 ]
Yamada, Gen [1 ]
Yamamoto, Kei [1 ]
Ohmagari, Norio [1 ,3 ,5 ]
机构
[1] Natl Ctr Global Hlth & Med, Dis Control & Prevent Ctr, Dept Infect Dis, Tokyo, Japan
[2] Kyushu Univ Hosp, Dept Gen Internal Med, Fukuoka, Japan
[3] Natl Ctr Global Hlth & Med, AMR Clin Reference Ctr, Tokyo, Japan
[4] Univ Antwerp, Fac Med & Hlth Sci, Antwerp, Belgium
[5] Tohoku Univ, Grad Sch Med, Emerging & Reemerging Infect Dis, Sendai, Miyagi, Japan
[6] 1-21-1 Toyama,Shinjuku Ku, Tokyo 1628655, Japan
关键词
Older adults; Aging; Bloodstream infection; Community-acquired; Health care-associated; Hospital-onset; BLOOD-STREAM INFECTIONS; STAPHYLOCOCCUS-AUREUS BACTEREMIA; RISK-FACTORS; DISEASE CONSULTATION; MORTALITY; CULTURES; NATIONWIDE; HOSPITALS; FUNGEMIA; IMPACT;
D O I
10.1016/j.jiac.2023.06.015
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background: The characteristics and clinical consequences of bacteremia in older people, who are highly susceptible to infections, need to be clarified. This study aimed to determine the epidemiological characteristics, prognosis, and predictors of 7-day mortality in patients with community-acquired (CA), healthcare-associated (HCA), and hospital-onset (HO) bacteremia in older adults aged =65 years.Methods: Patients aged =65 years with positive blood cultures between April 1, 2015, and March 31, 2018, were divided into three groups: pre-old (65-74 years), old (75-89 years), and super-old (=90 years). Characteristics based on medical exposure, including CA, HCA, and HO, were also compared and factors related to mortality were identified.Results: Overall, 1716 episodes of bacteremia were identified in 1415 patients. Of the 1211 episodes without contamination, 32.8%, 54.3%, and 12.9% occurred in pre-old, old, and super-old patients. Central line-associated bloodstream infections were more common in pre-old patients and urinary tract infections in the old and super old. The 7-day mortality rates in the pre-old, old, and super-old groups were 7.4%, 5.8%, and 14.2% (P = 0.002), respectively. Multivariable logistic regression showed that super-old age (adjusted odds ratio, aOR: 2.09 [1.13-3.88], P = 0.019) and HO bacteremia (aOR: 1.97 [1.18-3.28], P = 0.010) were independent risk factors for 7-day mortality. Infectious disease consultation had a protective effect on 7-day mortality (aOR: 0.59 [0.35-0.99], P = 0.047).Conclusions: The epidemiology of bacteremia differs among older people; thus, they should not be treated as a single entity. A careful approach is needed for the optimal management of bacteremia in these vulnerable patients.
引用
收藏
页码:971 / 977
页数:7
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