[Epidemiological features of community- and nosocomial-acquired bacteremia in the hospitalized elderly patients].
OBJECTIVE
To analyze the epidemiology and to identify associated factors for community- and nosocomial-acquired bacteremia in the elderly (BE).


METHODS
Elderly patients diagnosed of bacteremia were selected. Community- or acquired-bacteremia were defined according to standard criteria. The severity of underlying diseases was classified as non-fatal, ultimately fatal, or rapidly fatal, according to McCabe-Jackson criteria. Multivariate analysis by logistic regression was used to identify associated factors to bacteremia.


RESULTS
Two hundred and forty-two cases of BE were selected. The mean age was 72.5 years, 50% occurred in males. One hundred and thirty cases (53.7%) were community-acquired and 112 (46.3%) cases were nosocomial-acquired BE. Most common underlying diseases were diabetes mellitus (30.6%%), chronic obstructive pulmonary disease (25.6%) and neoplasia (24%). Gram-negative bacteria were more frequently isolated in community-acquired BE, while gram-positive cocci were more common in nosocomial-acquired BE. Sources of infection were: vascular (19%), respiratory tract (18.6%), biliary tract (17.8%) and urinary tract (8.3%). The factors associated with nosocomial-acquired BE were (adjusted OR; 95%CI): underlying diseases (5.4; 2.7-10.8), neoplasia (2.5; 1.3-4.9) and vascular origin (2.2; 1.1-4.5). Fifty-two patients died (23.1%).


CONCLUSIONS
BE occurs in elderly patients debilitated with well-defined underlying diseases. BE is associated to high mortality.
García Ordóñez
M A
MA
Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Complejo Hospitalario Carlos Haya, Málaga. miguel.garcia.sspa@juntadeandalucia.es
Moya Benedicto
R
R
López González
J J
JJ
Colmenero Castillo
J D
JD
D000368:Aged; D016470:Bacteremia / Q000453:epidemiology*; D015984:Causality; D017714:Community-Acquired Infections / Q000453:epidemiology*; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male