A prospective study of epidemiology characteristics and outcomes of bloodstream infections in older patients.

ABSTRACT

OBJECTIVE: This study aimed to investigate the characteristics of bloodstream infections (BSIs) in older patients and describe the differences between community-acquired, hospital-acquired and health care-associated BSIs. METHODS: A prospective observational study was conducted at the University Hospital of Heraklion, Crete, Greece. Epidemiology, clinical characteristics and outcomes of BSIs were recorded. RESULTS: During a four-year period, 113 BSIs were recorded. Of them, 42% occurred in male patients; patients' mean age was 80 years. BSIs were community-acquired in 76% of patients, hospital-acquired in 12% and health care-associated in 12%. The most commonly isolated bacteria were E coli and K pneumoniae. Thirty-day mortality from detection of BSIs was 27%. Patients with fever, without septic shock and with appropriate empirical treatment were less likely to die. CONCLUSION: Community-acquired, health care-associated and hospital-acquired BSIs had different presentation, microbiology and outcomes. Older patients had a high mortality. The absence of fever, inappropriate empirical treatment and septic shock were independent mortality predictors.