Bacterial infection in elderly nursing home and community-based patients: a prospective cohort study.

ABSTRACT

PURPOSE: The aim of the study was to assess differences between elderly nursing home (NH) residents and elderly patients living in the community admitted to hospital for bacterial infection. METHODS: We conducted a prospective cohort study with manual data collection. Patients aged 65 years and older from NHs and from the community admitted to hospital for bacterial infection were included in the study. Patient characteristics, site of infection, microorganism profile, and final outcome were assessed and compared between these two subgroups of patients. RESULTS: Two hundred and sixty-two patients were from NHs and 707 were from the community. Patients from NHs were older, had more underlying chronic illnesses, and more often showed characteristics indicating advanced debility. In both groups, the most common site of infection was the respiratory tract. In comparison to the community group, patients from NHs had a higher fatality rate (23.3 vs. 10.9%) and more often experienced functional decline at discharge (27.5 vs. 16.8%). After adjustment for age, sex, presence of comorbidity, and debility, NH residence remained associated with increased in-hospital mortality but not with functional decline. CONCLUSIONS: Elderly patients from NHs admitted to hospital for bacterial infection are older and more debilitated than their counterparts from the community. Microorganisms found in the NH residents are somewhat different from those in the community dwellers. The community dwellers had a better survival rate than those admitted from the NHs after adjusting for age, sex, presence of any comorbidity, and debility.