title: Epidemiology of bloodstream infection in nursing home residents: evaluation in a large cohort from multiple homes.
abstract: This study sought to reevaluate the epidemiology of bloodstream infection in nursing home residents. The records of 166 nursing home residents admitted to an urban, public, university-affiliated hospital with 169 episodes of bloodstream infection between January 1997 and April 2000 were retrospectively reviewed. The most common organisms isolated were Escherichia coli (27% of isolates), Staphylococcus aureus (18%; 29% were methicillin-resistant strains), and Proteus mirabilis (13%). There was minimal resistance to quinolones and third-generation cephalosporins among aerobic gram-negative bacilli. The most common sources were the urinary tract (51% of episodes) and the lungs (11%); a source was not identified in 22% of episodes. Hospital mortality was 18%. Independent predictors of hospital mortality were a pulmonary source of infection, systolic blood pressure <90 mm Hg, and leukocytosis >20,000 cells/mm3. Compared with other studies published in the past 2 decades, mortality was lower. The most common resistant organism was methicillin-resistant S. aureus.
authors.affiliation: Department of Medicine, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA. mylotte@buffalo.edu
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Mylotte
authors.forename: Ammar
authors.initials: A
authors.lastname: Tayara
authors.forename: Susan
authors.initials: S
authors.lastname: Goodnough
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes; D012189:Retrospective Studies; D018805:Sepsis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents