Infection in the elderly.
One hundred and eleven patients with pyogenic infections were studied. Of these, 32 patients (28.8%) were diabetic, and 33 patients (30%) had positive cultures obtained. Fifty-eight patients (52.3%) had fever (T degrees greater than 37.2 degrees C) while 69 patients (62.2%) had leucocytosis. Forty-one patients (36.9%) had nosocomial infections. It was found that patients older than 75 years-old did not respond to infection by a febrile response as often as those younger than 75 years-old. Mortality rate was increased in those whose T degrees greater than 38.2 degrees C and in those with more than one source of infection. Age and the presence of diabetes was not found to increase the mortality rate, though diabetics tend to have more than one source of infection. A positive blood culture was also associated with a higher mortality rate. There were also more deaths among patients with nosocomial infection than the community acquired group. The three most common sources of infection were lung, urinary tract and skin respectively. The most common group of organisms cultured was gram negative bacilli, of which Klebsiella species was most frequently isolated. Of these, 57% of the Klebsiella sp cultured came from the nosocomial group. Staphylococcus aureus was the next most frequently cultured bacteria, and all these isolates (100%) came from the nosocomial group. Though antibiotics were started within 48 hours of suspicion of infection in majority of patients (101 patients or 91%), and all of these received appropriate initial antibiotics, mortality rate remained high (26 deaths or 23.4%).
Chan
K M
KM
Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore.
Chee
Y C
YC
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000209:etiology* / Q000401:mortality; D003428:Cross Infection / Q000150:complications; D048909:Diabetes Complications; D005260:Female; D005334:Fever; D006801:Humans; D007964:Leukocytosis / Q000150:complications; D008297:Male; D011446:Prospective Studies; D012846:Singapore / Q000453:epidemiology