Community-acquired bacteremia in the elderly: a prospective study of 121 cases.
OBJECTIVE
To describe community-acquired bacteremia in the elderly and correlate clinical and laboratory findings with outcome.


METHODS
Prospective study of consecutive cases.


METHODS
Large community-based teaching hospital.


METHODS
One hundred and twenty-one elderly patients aged 65 to 89 years, seen between February 1, 1986 and January 31, 1988.


METHODS
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.


CONCLUSIONS
Community-acquired bacteremia in the elderly has a high mortality rate. Early recognition and prompt, appropriate treatment are critical in reducing the mortality.
Whitelaw
D A
DA
Department of Medicine, Groote Schuur Hospital, Observatory, Cape, South Africa.
Rayner
B L
BL
Willcox
P A
PA
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D015897:Comorbidity; D005260:Female; D017052:Hospital Mortality; D006764:Hospitals, Community; D006784:Hospitals, Teaching; D006801:Humans; D007902:Length of Stay; D008297:Male; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000150:complications / Q000453:epidemiology; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D015996:Survival Rate; D013997:Time Factors; D014552:Urinary Tract Infections / Q000150:complications / Q000453:epidemiology
D000900:Anti-Bacterial Agents