[Oropharyngeal colonization by Gram-negative bacteria in elderly hospitalized patients: incidence and risk factors].
OBJECTIVE
In a prospective study, we determined the predisposing conditions and the course of aerobic Gram-negative bacilli oropharyngeal colonization during the hospital stay in patients older than 70 years.


METHODS
We studied 116 patients admitted in our internal medicine unit. Medical characteristics were documented for each patient. Oropharyngeal swabs were collected on the first, third, and seventh days after admission, and then once a week until discharge. Positive culture was defined as the presence of at least one colony of Gram-negative bacilli.


RESULTS
We collected 306 samples from the 116 patients. The mean hospital stay was 10.6 days. Fifty patients (43%) had at least one positive oropharyngeal culture. Thirty-three patients (30%) were colonized on admission, but this prevalence decreased during hospital stay: 20% on the third day and 14% on the seventh day. In an univariate analysis, prior administration of antibiotics (P < 0.01) and use of nonsteroid anti-inflammatory drugs (P < 0.05) were associated with colonization.


CONCLUSIONS
Aerobic Gram-negative bacilli oropharyngeal colonization was transient during the hospital stay in the elderly. The use of nonsteroidal anti-inflammatory drugs and the previous treatment with antibiotics are possible risk factors for colonization.
Hiar
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Service de médecine interne et maladies infectieuses, CHU, boulevard Tanguy-Prigent, 29609 Brest, France.
Tandé
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D
Gentric
A
A
Garré
M
M
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003428:Cross Infection; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D009960:Oropharynx / Q000382:microbiology* / Q000473:pathology*; D011446:Prospective Studies; D012307:Risk Factors
D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal