[Descriptive study of bacteremia in a geriatric hospital].
OBJECTIVE
To describe clinical features, microbiologic characteristics and outcome of bacteremia in the elderly patients hospitalized in a geriatric hospital.


METHODS
All episodes of bacteremia diagnosed from January 1(st) to December 31(st) 1998 were analysed, excluding false-positive cases due to skin contamination. The hospital comprises 1084 geriatric beds distributed as 111 in acute care (ACF), 333 in rehabilitation and intermediate-care (RICF), and 516 in long-term-care facilities (LTCF).


RESULTS
Sixty-six episodes of bacteremia were observed in 65 patients. Among them 59 (89%) were nosocomial bacteremia distributed as 20 in ACF, 29 in RICF and 10 in LTCF (rates of 0.6, 0.35, and 0.05 episodes per 1000 patient-days, respectively.). Escherichia coli and Staphylococcus aureus were the main bacterial species involved in 31% and 28% of the cases, respectively. E. coli strains were 50% resistant to amoxicillin and 41% resistant to co-amoxiclav, and 68% of S. aureus strains were resistant to methicillin. Portals of entry were urinary tract (44%), respiratory tract (14%), digestive tract (11%), and soft tissue (8%). The same bacterial strain as in bacteremia was isolated from a peripheric site in 30 cases (47%), most of them being urines. For 15% cases, portal of entry cannot be determined. Mortality associated to nosocomial bacteremia was 25%, and death was significantly associated to MRSA, urinary or intravascular devices, chronic wounds and inappropriate antibiotic prescription.


CONCLUSIONS
In geriatric hospitals, bacteremia are mainly nosocomial cases. Prevention should focus on indwelling devices and antibiotic resistance.
Moumile
K
K
Laboratoire de Microbiologie-Hygiène, Groupe Hospitalier Charles Foix-Jean Rostand, 7 avenue de la république, 94205 Ivry Sur Seine Cedex, Assistance Publique-Hôpitaux de Paris, Ivry Sur Seine, France.
Carbonne
A
A
Rouquet
M-L
ML
Gamard
M-N
MN
Bornand-Rousselot
A
A
Jarlier
V
V
Cambau
E
E
D000368:Aged; D016470:Bacteremia / Q000453:epidemiology* / Q000401:mortality; D004927:Escherichia coli Infections / Q000453:epidemiology; D005602:France / Q000453:epidemiology; D006746:Hospital Bed Capacity, 500 and over / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006782:Hospitals, Special; D006801:Humans; D007902:Length of Stay; D013290:Streptococcal Infections / Q000453:epidemiology