Risk factors and mortality for nosocomial bloodstream infections in elderly patients

Reunes, S.; Rombaut, V.; Vogelaers, D.; Brusselaers, N.; Lizy, C.; Cankurtaran, M.; Labeau, S.; Petrovic, M.; Blot, S.

doi:10.1016/J.EJIM.2011.02.004

Title

Risk factors and mortality for nosocomial bloodstream infections in elderly patients

Author

Reunes, S.

Rombaut, V.

Vogelaers, D.

Brusselaers, N.

Lizy, C.

Cankurtaran, M.

Labeau, S.

Petrovic, M.

Blot, S.

Abstract

Objective: To determine risk factors for nosocomial bloodstream infection (BSI) and associated mortality in geriatric patients in geriatric and internal medicine wards at a university hospital. Methods: Single-center retrospective (1992-2007), pairwise-matched (1:1-ratio) cohort study. Geriatric patients with nosocomial BSI were matched with controls without BSI on year of admission and length of hospitalization before onset of BSI. Demographic, microbiological, and clinical data are collected. Results: One-hundred forty-two BSI occurred in 129 patients. Predominant microorganisms were Escherichia coli (23.2%), coagulase-negative Staphylococci (19.4%), Pseudomonas aeruginosa (8.4%), Staphylococcus aureus (7.1%), Klebsiella pneumoniae (5.8%) and Candida spp. (5.8%). Matching was successful for 109 cases. Compared to matched control subjects, cases were more frequently female, suffered more frequently from arthrosis, angina pectoris and pressure ulcers, had worse Activities of Daily Living-scores, had more often an intravenous or bladder catheter, and were more often bedridden. Logistic regression demonstrated presence of an intravenous catheter (odds ratio [OR] 7.5, 95% confidence interval [CI] 2.5-22.9) and being bedridden (OR 2.9, 95% CI 1.6-5.3) as independent risk factors for BSI. In univariate analysis nosocomial BSI was associated with increased mortality (22.0% vs. 11.0%; P=0.029). After adjustment for confounding co-variates, however, nosocomial BSI was not associated with mortality (hazard ratio 1.3, 95% CI 0.6-2.6). Being bedridden and increasing age were independent risk factors for death. Conclusion: Intravenous catheters and being bedridden are the main risk factors for nosocomial BSI. Although associated with higher mortality, this infectious complication seems not to be an independent risk factor for death in geriatric patients. (C) 2011 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Language

English

Source (journal)

European journal of internal medicine. - Basingstoke

Publication

Basingstoke : 2011

ISSN

0953-6205

DOI

10.1016/J.EJIM.2011.02.004

Volume/pages

22 :5 (2011) , p. E39-E44