Bloodstream infections in older patients

1. National Center for Chronic Disease Prevention and Health Promotion DoPH, CDC. The state of aging and health in America;
2013:2013 [Google Scholar]

2. Gavazzi G, Krause KH. Ageing and infection. Lancet Infect Dis
2002; 2(11):659-66; PMID:12409046; http://dx.doi.org/ 10.1016/S1473-3099(02)00437-1 [PubMed] [CrossRef] [Google Scholar]

3. Reunes S, Rombaut V, Vogelaers D, Brusselaers N, Lizy C, Cankurtaran M, Labeau S, Petrovic M, Blot S.
Risk factors and mortality for nosocomial bloodstream infections in elderly patients. Eur J Int Med
2011; 22(5):e39-44; http://dx.doi.org/ 10.1016/j.ejim.2011.02.004 [PubMed] [CrossRef] [Google Scholar]

4. Yoshikawa TT. Epidemiology and unique aspects of aging and infectious diseases. Clin Infect Dis
2000; 30(6):931-3; PMID:10880303; http://dx.doi.org/ 10.1086/313792 [PubMed] [CrossRef] [Google Scholar]

5. Girard TD, Opal SM, Ely EW. Insights into severe sepsis in older patients: from epidemiology to evidence-based management. Clin Infect Dis
2005; 40(5):719-27; PMID:15714419; http://dx.doi.org/ 10.1086/427876 [PubMed] [CrossRef] [Google Scholar]

6. Beckett CL, Harbarth S, Huttner B. Special considerations of antibiotic prescription in the geriatric population. Clin Microbiol Infect
2015; 21(1):3-9; PMID:25636920; http://dx.doi.org/ 10.1016/j.cmi.2014.08.018 [PubMed] [CrossRef] [Google Scholar]

7. Goto M, Al-Hasan MN. Overall burden of bloodstream infection and nosocomial bloodstream infection in North America and Europe. Clin Microbiol Infect
2013; 19(6):501-9; PMID:23473333; http://dx.doi.org/ 10.1111/1469-0691.12195 [PubMed] [CrossRef] [Google Scholar]

8. Pien BC, Sundaram P, Raoof N, Costa SF, Mirrett S, Woods CW, Reller LB, Weinstein MP. The clinical and prognostic importance of positive blood cultures in adults. Am J Med
2010; 123(9):819-28; PMID:20800151; http://dx.doi.org/ 10.1016/j.amjmed.2010.03.021 [PubMed] [CrossRef] [Google Scholar]

9. Skogberg K, Lyytikainen O, Ollgren J, Nuorti JP, Ruutu P. Population-based burden of bloodstream infections in Finland. Clin Microbiol Infect
2012; 18(6):E170-6; PMID:22512663; http://dx.doi.org/ 10.1111/j.1469-0691.2012.03845.x [PubMed] [CrossRef] [Google Scholar]

10. Eliakim-Raz N, Bates DW, Leibovici L. Predicting bacteraemia in validated models-a systematic review. Clin Microbiol Infect
2015; 21(4):295-301; PMID:25677625; http://dx.doi.org/ 10.1016/j.cmi.2015.01.023 [PubMed] [CrossRef] [Google Scholar]

11. Leibovici L, Pitlik SD, Konisberger H, Drucker M. Bloodstream infections in patients older than eighty years. Age Ageing
1993; 22(6):431-42; PMID:8310889; http://dx.doi.org/ 10.1093/ageing/22.6.431 [PubMed] [CrossRef] [Google Scholar]

12. Uslan DZ, Crane SJ, Steckelberg JM, Cockerill FR 3rd, St Sauver JL, Wilson WR, Baddour LM.
Age- and sex-associated trends in bloodstream infection: a population-based study in Olmsted County, Minnesota. Arch Int Med
2007; 167(8):834-9; http://dx.doi.org/ 10.1001/archinte.167.8.834 [PubMed] [CrossRef] [Google Scholar]

13. Blot S, Cankurtaran M, Petrovic M, Vandijck D, Lizy C, Decruyenaere J, Danneels C, Vandewoude K, Piette A, Vershraegen G, et al..
Epidemiology and outcome of nosocomial bloodstream infection in elderly critically ill patients: a comparison between middle-aged, old, and very old patients. Critical Care Med
2009; 37(5):1634-41; http://dx.doi.org/ 10.1097/CCM.0b013e31819da98e [PubMed] [CrossRef] [Google Scholar]

14. Hernandez C, Feher C, Soriano A, Marco F, Almela M, Cobos-Trigueros N, De La Calle C, Morata L, Mensa J, Martínez JA. Clinical characteristics and outcome of elderly patients with community-onset bacteremia. J Infect
2015; 70(2):135-43; PMID:25224642; http://dx.doi.org/ 10.1016/j.jinf.2014.09.002 [PubMed] [CrossRef] [Google Scholar]

15. Kaye KS, Marchaim D, Chen TY, Chopra T, Anderson DJ, Choi Y, Sloane R, Schmader KE.
Predictors of nosocomial bloodstream infections in older adults. J Am Geriatrics Society
2011; 59(4):622-7; http://dx.doi.org/ 10.1111/j.1532-5415. 2010.03289.x [PubMed] [CrossRef] [Google Scholar]

16. Kollef MH, Zilberberg MD, Shorr AF, Vo L, Schein J, Micek ST, Kim M. Epidemiology, microbiology and outcomes of healthcare-associated and community-acquired bacteremia: a multicenter cohort study. J Infect
2011; 62(2):130-5; PMID:21195110; http://dx.doi.org/ 10.1016/j.jinf.2010.12.009 [PubMed] [CrossRef] [Google Scholar]

17. Chassagne P, Perol MB, Doucet J, Trivalle C, Menard JF, Manchon ND, Moynot Y, Humbert G, Bourreille J, Bercoff E. Is presentation of bacteremia in the elderly the same as in younger patients? The American journal of medicine
1996; 100(1):65-70; PMID:8579089 [PubMed] [Google Scholar]

18. Gleckman R, Hibert D. Afebrile bacteremia. A phenomenon in geriatric patients. Jama
1982; 248(12):1478-81; PMID:7109169; http://dx.doi.org/ 10.1001/jama.1982.03330120036026 [PubMed] [CrossRef] [Google Scholar]

19. Green JE, Ariathianto Y, Wong SM, Aboltins C, Lim K. Clinical and inflammatory response to bloodstream infections in octogenarians. BMC Geriatrics
2014; 14:55; PMID:24754903; http://dx.doi.org/ 10.1186/1471-2318-14-55 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

20. Lee CC, Chen SY, Chang IJ, Chen SC, Wu SC.
Comparison of clinical manifestations and outcome of community-acquired bloodstream infections among the oldest old, elderly, and adult patients. Med
2007; 86(3):138-44; http://dx.doi.org/ 10.1097/SHK.0b013e318067da56 [PubMed] [CrossRef] [Google Scholar]

21. Pfitzenmeyer P, Decrey H, Auckenthaler R, Michel JP.
Predicting bacteremia in older patients. J Am Geriatrics Soc
1995; 43(3):230-5; http://dx.doi.org/ 10.1111/j.1532-5415.1995.tb07327.x [PubMed] [CrossRef] [Google Scholar]

22. Wester AL, Dunlop O, Melby KK, Dahle UR, Wyller TB. Age-related differences in symptoms, diagnosis and prognosis of bacteremia. BMC Infect Dis
2013; 13:346; PMID:23883345; http://dx.doi.org/ 10.1186/1471-2334-13-346 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

23. Yahav D, Schlesinger A, Daitch V, Akayzen Y, Farbman L, Abu-Ghanem Y, Paul M, Leibovici L.
Presentation of infection in older patients–a prospective study. Annals Med
2015; 47(4):354-8; http://dx.doi.org/ 10.3109/07853890.2015.1019915 [PubMed] [CrossRef] [Google Scholar]

24. Leibovici L, Samra Z, Konigsberger H, Drucker M, Ashkenazi S, Pitlik SD. Long-term survival following bacteremia or fungemia. Jama
1995; 274(10):807-12; PMID:7650804; http://dx.doi.org/ 10.1001/jama.1995.03530100047033 [PubMed] [CrossRef] [Google Scholar]

25. Fontanarosa PB, Kaeberlein FJ, Gerson LW, Thomson RB.
Difficulty in predicting bacteremia in elderly emergency patients. Annals Emergency Med
1992; 21(7):842-8; http://dx.doi.org/ 10.1016/S0196-0644(05)81032-7 [PubMed] [CrossRef] [Google Scholar]

26. Darowski A, Najim Z, Weinberg J, Guz A. The febrile response to mild infections in elderly hospital inpatients. Age Ageing
1991; 20(3):193-8; PMID:1853793; http://dx.doi.org/ 10.1093/ageing/20.3.193 [PubMed] [CrossRef] [Google Scholar]

27. Darowski A, Najim Z, Weinberg JR, Guz A. The increase in body temperature of elderly patients in the first twenty-four hours following admission to hospital. Age Ageing
1991; 20(2):107-12; PMID:2053498; http://dx.doi.org/ 10.1093/ageing/20.2.107 [PubMed] [CrossRef] [Google Scholar]

28. Meyers BR, Sherman E, Mendelson MH, Velasquez G, Srulevitch-Chin E, Hubbard M, Hirschman SZ. Bloodstream infections in the elderly. Am J Med
1989; 86(4):379-84; PMID:2929625; http://dx.doi.org/ 10.1016/0002-9343(89)90333-1 [PubMed] [CrossRef] [Google Scholar]

29. Rebelo M, Pereira B, Lima J, Decq-Mota J, Vieira JD, Costa JN. Predictors of in-hospital mortality in elderly patients with bacteraemia admitted to an Internal Medicine ward. Int Arch Med
2011; 4(1):33; PMID:21970460; http://dx.doi.org/ 10.1186/1755-7682-4-33 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

30. van Duin D. Diagnostic challenges and opportunities in older adults with infectious diseases. Clin Infect Dis
2012; 54(7):973-8; PMID:22186775; http://dx. doi.org/ 10.1093/cid/cir927 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

31. Brun-Buisson C, Doyon F, Carlet J.
Bacteremia and severe sepsis in adults: a multicenter prospective survey in ICUs and wards of 24 hospitals. French Bacteremia-Sepsis Study Group. Am J Respiratory Critical Care Med
1996; 154(3 Pt 1):617-24; http://dx.doi.org/ 10.1164/ajrccm.154.3.8810595 [PubMed] [CrossRef] [Google Scholar]

32. Nasa P, Juneja D, Singh O. Severe sepsis and septic shock in the elderly: An overview. World J Crit Care Med
2012; 1(1):23-30; PMID:24701398; http://dx.doi.org/ 10.5492/wjccm.v1.i1.23 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

33. Sogaard M, Schonheyder HC, Riis A, Sorensen HT, Norgaard M.
Short-term mortality in relation to age and comorbidity in older adults with community-acquired bacteremia: a population-based cohort study. J Am Geriatrics Society
2008; 56(9):1593-600; http://dx.doi.org/ 10.1111/j.1532-5415.2008.01855.x [PubMed] [CrossRef] [Google Scholar]

34. Munoz-Gamito G, Calbo-Sebastian E, Riera-Garcia M, Xercavins-Valls M, Rodriguez-Carballeira M, Garau-Alemany J. (Bloodstream infection in the up to 80 year-old-patients). Revista Clinica Espanola
2012; 212(6):273-80; PMID:22520154; http://dx.doi.org/ 10.1016/j.rce.2012.02.013 [PubMed] [CrossRef] [Google Scholar]

35. Gavazzi G, Mallaret MR, Couturier P, Iffenecker A, Franco A.
Bloodstream infection: differences between young-old, old, and old-old patients. J Am Geriatrics Society
2002; 50(10):1667-73; http://dx.doi.org/ 10.1046/j.1532-5415.2002.50458.x [PubMed] [CrossRef] [Google Scholar]

36. Wang L, Lansing B, Symons K, Flannery EL, Fisch J, Cherian K, McNamara SE, Mody L. Infection rate and colonization with antibiotic-resistant organisms in skilled nursing facility residents with indwelling devices. Eur J Clin Microbiol Infect Dis
2012; 31(8):1797-804; PMID:22274858; http://dx.doi.org/ 10.1007/s10096-011-1504-7 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

37. Lark RL, Saint S, Chenoweth C, Zemencuk JK, Lipsky BA, Plorde JJ.
Four-year prospective evaluation of community-acquired bacteremia: epidemiology, microbiology, and patient outcome. Diagnostic Microbiol Infect Dis
2001; 41(1-2):15-22; http://dx.doi.org/ 10.1016/S0732-8893(01)00284-X [PubMed] [CrossRef] [Google Scholar]

38. Leibovici L, Greenshtain S, Cohen O, Wysenbeek AJ.
Toward improved empiric management of moderate to severe urinary tract infections. Arch Internal Med
1992; 152(12):2481-6;http://dx.doi.org/ 10.1001/archinte.1992.00400240097016 [PubMed] [CrossRef] [Google Scholar]

39. Rajagopalan S, Yoshikawa TT.
Antimicrobial therapy in the elderly. Medical Clin North Am
2001; 85(1):133-47, vii; http://dx.doi.org/ 10.1016/S0025-7125(05)70308-4 [PubMed] [CrossRef] [Google Scholar]

40. Greenberg BM, Atmar RL, Stager CE, Greenberg SB. Bacteraemia in the elderly: predictors of outcome in an urban teaching hospital. J Infect
2005; 50(4):288-95; PMID:15845426; http://dx. doi.org/ 10.1016/j.jinf.2004.06.014 [PubMed] [CrossRef] [Google Scholar]

41. Burlaud A, Mathieu D, Falissard B, Trivalle C.
Mortality and bloodstream infections in geriatrics units. Arch Gerontol Geriatrics
2010; 51(3):e106-9; http://dx.doi.org/ 10.1016/j.archger.2010.01.012 [PubMed] [CrossRef] [Google Scholar]

42. Girard TD, Ely EW.
Bacteremia and sepsis in older adults. Clin Geriatric Med
2007; 23(3):633-47 viii; http://dx.doi.org/ 10.1016/j.cger.2007.05.003 [PubMed] [CrossRef] [Google Scholar]

43. Martin GS, Mannino DM, Moss M.
The effect of age on the development and outcome of adult sepsis. Critical Care Med
2006; 34(1):15-21; http://dx.doi.org/ 10.1097/01.CCM.0000194535.82812.BA [PubMed] [CrossRef] [Google Scholar]

44. Diekema DJ, Pfaller MA, Jones RN, Group SP.
Age-related trends in pathogen frequency and antimicrobial susceptibility of bloodstream isolates in North America: SENTRY Antimicrobial Surveillance Program, 1997-2000. Int J Antimicrobial Agents
2002; 20(6):412-8; http://dx. doi.org/ 10.1016/S0924-8579(02)00204-2 [PubMed] [CrossRef] [Google Scholar]

45. Tiruvoipati R, Ong K, Gangopadhyay H, Arora S, Carney I, Botha J. Hypothermia predicts mortality in critically ill elderly patients with sepsis. BMC Geriatrics
2010; 10:70; PMID:20875107; http://dx.doi.org/ 10.1186/1471-2318-10-70 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

46. Retamar P, Lopez-Prieto MD, Rodriguez-Lopez F, de Cueto M, Garcia MV, Gonzalez-Galan V, Del Arco A, Pérez-Santos MJ, Téllez-Pérez F, Becerril-Carral B, et al..
Predictors of early mortality in very elderly patients with bacteremia: a prospective multicenter cohort. Int J Infect Dis
2014; 26:83-7; PMID:25008770; http://dx.doi.org/ 10.1016/j.ijid.2014.04.029 [PubMed] [CrossRef] [Google Scholar]

47. Payeras A, Garcia-Gasalla M, Garau M, Juan IRM, Pareja A, Cifuentes C, Homar F, Gallegos C, Bassa A.
Bacteremia in very elderly patients: risk factors, clinical characteristics and mortality. Enfermedades Infecciosas Y Microbiologia Clin
2007; 25(10):612-8; http://dx. doi.org/ 10.1157/13112936 [PubMed] [CrossRef] [Google Scholar]

48. Whitelaw DA, Rayner BL, Willcox PA.
Community-acquired bacteremia in the elderly: a prospective study of 121 cases. J Am Geriatrics Society
1992; 40(10):996-1000; http://dx.doi.org/ 10.1111/j.1532-5415.1992.tb04475.x [PubMed] [CrossRef] [Google Scholar]

49. Sogaard M, Norgaard M, Dethlefsen C, Schonheyder HC. Temporal changes in the incidence and 30-day mortality associated with bacteremia in hospitalized patients from 1992 through 2006: a population-based cohort study. Clin Infect Dis
2011; 52(1):61-9; PMID:21148521; http://dx.doi.org/ 10.1093/cid/ciq069 [PubMed] [CrossRef] [Google Scholar]

50. Kullberg BJ, Arendrup MC. Invasive Candidiasis. N Engl J Med
2015; 373(15):1445-56; PMID:26444731; http://dx.doi.org/ 10.1056/NEJMra1315399 [PubMed] [CrossRef] [Google Scholar]

51. Dyar OJ, Pagani L, Pulcini C. Strategies and challenges of antimicrobial stewardship in long-term care facilities. Clin Microbiol Infect
2015; 21(1):10-9; PMID:25636921; http://dx. doi.org/ 10.1016/j.cmi.2014.09.005 [PubMed] [CrossRef] [Google Scholar]

52. Lin MY, Lyles-Banks RD, Lolans K, Hines DW, Spear JB, Petrak R, Trick WE, Weinstein RA, Hayden MK. The importance of long-term acute care hospitals in the regional epidemiology of Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae. Clin Infect Dis
2013; 57(9):1246-52; PMID:23946222; http://dx.doi.org/ 10.1093/cid/cit500 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

53. Ben-Ami R, Schwaber MJ, Navon-Venezia S, Schwartz D, Giladi M, Chmelnitsky I, Leavitt A, Carmeli Y. Influx of extended-spectrum β-lactamase-producing enterobacteriaceae into the hospital. Clin Infect Dis
2006; 42(7):925-34; PMID:16511754; http://dx.doi.org/ 10.1086/500936 [PubMed] [CrossRef] [Google Scholar]

54. March A, Aschbacher R, Dhanji H, Livermore DM, Bottcher A, Sleghel F, Maggi S, Noale M, Larcher C, Woodford N. Colonization of residents and staff of a long-term-care facility and adjacent acute-care hospital geriatric unit by multiresistant bacteria. Clin Microbiol Infect
2010; 16(7):934-44; PMID:19686277; http://dx.doi.org/ 10.1111/j.1469-0691.2009.03024.x [PubMed] [CrossRef] [Google Scholar]

55. Schoevaerdts D, Verroken A, Huang TD, Frennet M, Berhin C, Jamart J, Bogaerts P, Swine C, Glupczynski Y. Multidrug-resistant bacteria colonization amongst patients newly admitted to a geriatric unit: a prospective cohort study. J Infect
2012; 65(2):109-18; PMID:22343066; http://dx.doi.org/ 10.1016/j.jinf.2012.02.004 [PubMed] [CrossRef] [Google Scholar]

56. Lim CJ, Cheng AC, Kennon J, Spelman D, Hale D, Melican G, Sidjabat HE, Paterson DL, Kong DC, Peleg AY.
Prevalence of multidrug-resistant organisms and risk factors for carriage in long-term care facilities: a nested case-control study. J Antimicrobial Chemotherapy
2014; 69(7):1972-80; http://dx.doi.org/ 10.1093/jac/dku077 [PubMed] [CrossRef] [Google Scholar]

57. March A, Aschbacher R, Pagani E, Sleghel F, Soelva G, Hopkins KL, Doumith M, Innocenti P, Burth J, Piazzani F, et al. .
Changes in colonization of residents and staff of a long-term care facility and an adjacent acute-care hospital geriatric unit by multidrug-resistant bacteria over a four-year period. Scandinavian J Infect Dis
2014; 46(2):114-22; http://dx.doi.org/ 10.3109/00365548.2013.859392 [PubMed] [CrossRef] [Google Scholar]

58. Denkinger CM, Grant AD, Denkinger M, Gautam S, D’Agata EM.
Increased multi-drug resistance among the elderly on admission to the hospital–a 12-year surveillance study. Arch Gerontol Geriatrics
2013; 56(1):227-30; http://dx.doi.org/ 10.1016/j.archger.2012.05.006 [PubMed] [CrossRef] [Google Scholar]

59. Pop-Vicas A, Tacconelli E, Gravenstein S, Lu B, D’Agata EM.
Influx of multidrug-resistant, gram-negative bacteria in the hospital setting and the role of elderly patients with bacterial bloodstream infection. Infect Control Hospital Epidemiol
2009; 30(4):325-31; http://dx.doi.org/ 10.1086/596608 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

60. Lillie PJ, Allen J, Hall C, Walsh C, Adams K, Thaker H, Moss P, Barlow GD. Long-term mortality following bloodstream infection. Clin Microbiol Infect. 2013; 19(10):955-60; PMID:23279454; http://dx.doi.org/ 10.1111/1469-0691.12101 [PubMed] [CrossRef] [Google Scholar]

61. Ismail NH, Lieu PK, Lien CT, Ling ML.
Bacteraemia in the elderly. Annals Acad Med Singapore
1997; 26(5):593-8 [PubMed] [Google Scholar]

62. McCue JD.
Gram-negative bacillary bacteremia in the elderly: incidence, ecology, etiology, and mortality. J Am Geriatrics Society
1987; 35(3):213-8; http://dx.doi.org/ 10.1111/j.1532-5415.1987.tb02311.x [PubMed] [CrossRef] [Google Scholar]

63. Gavazzi G, Escobar P, Olive F, Couturier P, Franco A. Nosocomial bacteremia in very old patients: predictors of mortality. Aging Clin Exp Res
2005; 17(4):337-42; PMID:16285201; http://dx.doi.org/ 10.1007/BF03324619 [PubMed] [CrossRef] [Google Scholar]

64. Deulofeu F, Cervello B, Capell S, Marti C, Mercade V.
Predictors of mortality in patients with bacteremia: the importance of functional status. J Am Geriatrics Society
1998; 46(1):14-8; http://dx.doi.org/ 10.1111/j.1532-5415.1998.tb01007.x [PubMed] [CrossRef] [Google Scholar]

65. Leibovici L. Long-term consequences of severe infections. Clin Microbiol Infect
2013; 19(6):510-2; PMID:23397980; http://dx.doi.org/ 10.1111/1469-0691.12160 [PubMed] [CrossRef] [Google Scholar]

66. Tacconelli E, Pop-Vicas AE, D’Agata EM.
Increased mortality among elderly patients with meticillin-resistant Staphylococcus aureus bacteraemia. J Hospital Infect
2006; 64(3):251-6; http://dx.doi.org/ 10.1016/j.jhin.2006.07.001 [PubMed] [CrossRef] [Google Scholar]

67. Malani PN, Rana MM, Banerjee M, Bradley SF.
Staphylococcus aureus bloodstream infections: the association between age and mortality and functional status. J Am Geriatrics Society
2008; 56(8):1485-9; http://dx.doi.org/ 10.1111/j.1532-5415.2008.01823.x [PubMed] [CrossRef] [Google Scholar]

68. Ely EW, Angus DC, Williams MD, Bates B, Qualy R, Bernard GR. Drotrecogin alfa (activated) treatment of older patients with severe sepsis. Clin Infect Dis
2003; 37(2):187-95; PMID:12856210; http://dx.doi.org/ 10.1086/375775 [PubMed] [CrossRef] [Google Scholar]

69. Iwashyna TJ, Cooke CR, Wunsch H, Kahn JM.
Population burden of long-term survivorship after severe sepsis in older Americans. J Am Geriatrics Society
2012; 60(6):1070-7; http://dx.doi.org/ 10.1111/j.1532-5415.2012.03989.x [PMC free article] [PubMed] [CrossRef] [Google Scholar]

70. Iwashyna TJ, Ely EW, Smith DM, Langa KM. Long-term cognitive impairment and functional disability among survivors of severe sepsis. Jama
2010; 304(16):1787-94; PMID:20978258; http://dx.doi.org/ 10.1001/jama.2010.1553 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

71. Heyland DK, Hopman W, Coo H, Tranmer J, McColl MA.
Long-term health-related quality of life in survivors of sepsis. Short Form 36: a valid and reliable measure of health-related quality of life. Critical Care Med
2000; 28(11):3599-605; http://dx.doi.org/ 10.1097/00003246-200011000-00006 [PubMed] [CrossRef] [Google Scholar]

72. High KP, Bradley S, Loeb M, Palmer R, Quagliarello V, Yoshikawa T. A new paradigm for clinical investigation of infectious syndromes in older adults: assessment of functional status as a risk factor and outcome measure. Clin Infect Dis
2005; 40(1):114-22; PMID:15614700 [PubMed] [Google Scholar]

73. Leibovici L, Paul M. Ethical dilemmas in antibiotic treatment: focus on the elderly. Clin Microbiol Infect
2015; 21(1):27-9; PMID:25636923; http://dx.doi.org/ 10.1016/j.cmi.2014.10.013 [PubMed] [CrossRef] [Google Scholar]

74. Corsonello A, Abbatecola AM, Fusco S, Luciani F, Marino A, Catalano S, Maggio MG, Lattanzio F. The impact of drug interactions and polypharmacy on antimicrobial therapy in the elderly. Clin Microbiol Infect
2015; 21(1):20-6; PMID:25636922 [PubMed] [Google Scholar]

75. Big C, Malani PN.
Staphylococcus aureus bloodstream infections in older adults: clinical outcomes and risk factors for in-hospital mortality. J Am Geriatrics Society
2010; 58(2):300-5; http://dx. doi.org/ 10.1111/j.1532-5415.2009.02666.x [PubMed] [CrossRef] [Google Scholar]

76. Durante-Mangoni E, Bradley S, Selton-Suty C, Tripodi MF, Barsic B, Bouza E, Cabell CH, Ramos AI, Fowler V Jr, Hoen B, et al..
Current features of infective endocarditis in elderly patients: results of the International Collaboration on Endocarditis Prospective Cohort Study. Arch Int Med
2008; 168(19):2095-103; http://dx.doi.org/ 10.1001/archinte.168.19.2095 [PubMed] [CrossRef] [Google Scholar]

77. Paul M, Shani V, Muchtar E, Kariv G, Robenshtok E, Leibovici L. Systematic review and meta-analysis of the efficacy of appropriate empiric antibiotic therapy for sepsis. Antimicrob Agents Chemother
2010; 54(11):4851-63; PMID:20733044; http://dx.doi.org/ 10.1128/AAC.00627-10 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

78. Reisfeld S, Paul M, Gottesman BS, Shitrit P, Leibovici L, Chowers M. The effect of empiric antibiotic therapy on mortality in debilitated patients with dementia. Eur J Clin Microbiol Infect Dis
2011; 30(6):813-8; PMID:21267621 [PubMed] [Google Scholar]

79. Leibovici L, Paul M, Ezra O.
Ethical dilemmas in antibiotic treatment. J Antimicrobial Chemotherapy
2012; 67(1):12-6; http://dx.doi.org/ 10.1093/jac/dkr425 [PubMed] [CrossRef] [Google Scholar]

80. Avni T, Shiver-Ofer S, Leibovici L, Tacconelli E, DeAngelis G, Cookson B, Pagani L, Paul M.
Participation of elderly adults in randomized controlled trials addressing antibiotic treatment of pneumonia. J Am Geriatrics Society
2015; 63(2):233-43; http://dx.doi.org/ 10.1111/jgs.13250 [PubMed] [CrossRef] [Google Scholar]

81. Paul M, Bishara J, Yahav D, Goldberg E, Neuberger A, Ghanem-Zoubi N, Dickstein Y, Nseir W, Dan M, Leibovici L. Trimethoprim-sulfamethoxazole vs. vancomycin for severe infections caused by meticillin resistant Staphylococcus aureus: randomised controlled trial. BMJ
2015; 350:h3219; PMID:25977146; http://dx.doi.org/ 10.1136/bmj.h3219 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

82. Falagas ME, Vouloumanou EK, Sgouros K, Athanasiou S, Peppas G, Siempos II.
Patients included in randomised controlled trials do not represent those seen in clinical practice: focus on antimicrobial agents. Int J Antimicrobial Agents
2010; 36(1):1-13; http://dx.doi.org/ 10.1016/j.ijantimicag.2010.03.020 [PubMed] [CrossRef] [Google Scholar]

83. Juthani-Mehta M, Quagliarello VJ. Prognostic scoring systems for infectious diseases: their applicability to the care of older adults. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2004;38(5):692-6; PMID:14986254 [PubMed] [Google Scholar]

84. Hooton TM, Bradley SF, Cardenas DD, Colgan R, Geerlings SE, Rice JC, Saint S, Schaeffer AJ, Tambayh PA, Tenke P, et al..
Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clin Infect Dis
2010;50(5):625-63; PMID:20175247; http://dx.doi.org/ 10.1086/650482 [PubMed] [CrossRef] [Google Scholar]

85. Esposito AL, Gleckman RA, Cram S, Crowley M, McCabe F, Drapkin MS.
Community-acquired bacteremia in the elderly: analysis of one hundred consecutive episodes. J Am Geriatrics Society
1980; 28(7):315-9; http://dx.doi.org/ 10.1111/j.1532-5415.1980.tb00622.x [PubMed] [CrossRef] [Google Scholar]

86. Windsor AC. Bacteraemia in a geriatric unit. Gerontology
1983; 29(2):125-30; PMID:6840560; http://dx.doi.org/ 10.1159/000213104 [PubMed] [CrossRef] [Google Scholar]

87. Crane SJ, Uslan DZ, Baddour LM. Bloodstream infections in a geriatric cohort: a population-based study. Am J Med
2007; 120(12):1078-83; PMID:18060929; http://dx.doi.org/ 10.1016/j.amjmed.2007.08.028 [PubMed] [CrossRef] [Google Scholar]

Sepsis in Elderly Adults: What To Know

July 29, 2021

Subscribe

Along with old age comes many changes, some more subtle than others. For instance, older adults are at greater risk for infection and are more likely to experience atypical symptoms that can be more challenging to diagnose. Unfortunately, that also means older adults are at greater risk of sepsis. But what’s unique about sepsis in elderly patients, and what kinds of things do you need to be on the lookout to spot?

Sepsis in Elderly Patients – Things to Know

Sepsis refers to the inflammation response that occurs when our bodies are trying to fight off a bloodstream infection. This inflammatory response causes the body to damage itself, not unlike an ordinary fever, but with far greater risks.

Every year in the US, roughly three-quarters of a million people will develop sepsis, including a disproportionately large number of the elderly. In fact, one study of hospital discharge records found sepsis was nearly eight times more common among the elderly.

For older adults, the most common causes of sepsis are respiratory, genitourinary, or bloodstream infections. For instance, urinary sepsis in the elderly is when a UTI infection escapes into the bloodstream. Or pneumonia sepsis elderly patients have an infection that entered from the lungs but has since spread.

How Dangerous is Sepsis in the Elderly?

Unfortunately, death from sepsis in the elderly is quite common. Outside of coronary ICUs, it’s actually the second leading cause of death. It’s also worth noting the sepsis survival rate in elderly populations is quite distinct from younger adults. With only mild sepsis, a full recovery is the most common outcome. But for septic shock, the mortality rate is estimated to range between 25-40% – and closer to the higher end of that figure for the elderly.

As sepsis becomes worse, complications of sepsis in elderly patients will start to emerge. Those complications include organ damage, organ failure, and death.

A sepsis prognosis in the elderly can also be complicated because of the possibility of lasting damage from sepsis.

That’s because research has shown many of the older adults who survive a septic shock are at greater risk of entering a mental or physical decline in the years following. It’s also estimated And as many as 40% of those who survived a sepsis hospitalization died within the next two years.

Download Our Guide to Home Care

Avoiding Sepsis in Elderly Adults

Given the great danger involved, prompt treatment with antibiotic medications is usually of paramount importance to outcomes. As such, it’s also worth being familiar with some of the more common symptoms of sepsis, including confusion, rapid breathing, lower blood pressure, accelerated heart rate, severe pain, diarrhea, fatigue, fever, and lower body temperature.

Apart from early identification and treatment, prevention can be just as important. Fortunately, that’s often achievable by following some fairly common-sense guidelines, like washing your hands with soap, staying vaccinated, managing chronic conditions, and treating infections swiftly. And as always, healthy living goes a long way.

To learn more about our home care services, contact our caregiving team today at
(877) 268-3277 or
find a caregiver near you.

To learn more about our home care services,
contact our caregiving team today online or call us at
(877) 268-3277.

Categories

• Life Expectancy

• Prev Post
• Next Post

9 Signs of Sepsis You Shouldn’t Miss

Every second case of sepsis is fatal, so it’s important to know the 9 early signs and be on the lookout.

Tags:

Health problems

What do these symptoms mean?

Dangerous diseases

Blood poisoning or sepsis is a deadly disease, the main insidiousness of which is its secrecy: as a rule, it is very difficult to diagnose it in the early stages. Despite the fact that blood poisoning can be cured with antibiotics, almost every second case becomes fatal – mainly due to the fact that it was not detected in time. That is why it is imperative to know the early signs of blood poisoning in order to identify it in time and save the health and life of yourself or your loved ones.

Contents of the article

Do not self-medicate! In our articles, we collect the latest scientific data and the opinions of authoritative health experts. But remember: only a doctor can diagnose and prescribe treatment.

Fever

Sepsis occurs when a bacterial infection in any part of the body enters the bloodstream. And the first response of the body to such a lesion is usually a sharp increase in body temperature, often not accompanied by any other symptoms. Therefore, it is important to consult a doctor if you have an elevated body temperature for a long time.

Very low temperature

ADVERTISING – CONTINUED BELOW

At the same time, there are frequent cases when the penetration of an infection into the blood causes the opposite effect, and the body responds with a lower body temperature. This is also a very serious signal that should never be ignored: doctors warn that blood poisoning accompanied by a low temperature, as a rule, is less treatable and more often leads to serious consequences.

Chills

This is a frequent companion of high temperature, which in turn is a symptom of blood poisoning. It is especially important to report chills to the doctor, as this sensation is subjective and cannot be detected during a physical examination. Be sure to ask for help!

Pain and aches in the body

Another insidious symptom of blood poisoning that can easily be mistaken for a manifestation of a cold or flu is a feeling of aches or pain. With sepsis, pain can spread throughout the body, or it can be localized in one part of the body. If you feel unexplained pain, be sure to see a doctor as soon as possible!

Low blood pressure

This is one of the most serious symptoms of blood poisoning, and most often indicates that the infection has already penetrated very deeply and septic shock begins. In this condition, dehydration of blood vessels and loss of their elasticity occur. It is important to take action as soon as possible if your upper pressure is below 100.

Rapid pulse

In sepsis, the body tries to speed up the blood flow in the hope of getting rid of the infection sooner. and the most affordable way to do this is to increase the number of heartbeats. Therefore, a pulse whose frequency exceeds 90 beats per minute, may be a sign of blood poisoning. Do not ignore it, consult a doctor as soon as possible!

Shortness of breath

Shortness of breath with a respiratory rate of more than 22 breaths per minute is another sign of blood poisoning. The fact is that one of the most common causes of sepsis is pneumonia, in which less oxygen enters the blood – and the body tries to reduce the deficit by breathing more frequently. But even if the infection is not localized in the lungs, as the disease progresses, the body’s need for oxygen increases, and therefore breathing becomes more frequent. Therefore, it is important to see a doctor as soon as possible – it can save your life!

Paleness

By saving the brain and heart, the body can reduce blood flow to organs it considers less “important”, such as the skin, and thus cause paleness. Also, a visible symptom of blood poisoning can be spotting of the skin, as well as the appearance of cold sweat on them. Be sure to tell your doctor if you notice paleness in yourself or your loved ones, especially if it is combined with other symptoms listed above!

Weakness and drowsiness

Most often this symptom of blood poisoning is typical for elderly patients, but it also happens in younger patients and even children. Low blood pressure most often causes a feeling of fatigue, and in sepsis, the speed and filling of blood flow is reduced, which can lead to a feeling of weakness and drowsiness.

Blood poisoning – symptoms, signs

Such a pathology as blood poisoning after the body is damaged by any pathogenic microbes is a systemic – affecting various organs – inflammatory process provoked by infection. Medical workers often use the term “Sepsis” to refer to this pathology – literally translated from Greek means “putrefactive process”.

Blood infection after infection of this biological fluid with unicellular fungi or various types of pathogenic bacteria – staphylococci and streptococci, enterococci and meningococci, Pseudomonas aeruginosa, etc., is extremely difficult. It is important to understand that spontaneous recovery in a patient with such a disease cannot occur, and in the absence of qualified medical care, even a fatal outcome is not ruled out.

Causes of blood poisoning

The development of blood poisoning after the body is damaged by pathogens is more provoked not so much by the pathogenic properties of the pathogenic microorganism as by the weakened state of the patient’s immunity. If a person’s immune system has been seriously affected due to the presence of someone with a chronic sluggish disease, as well as due to the fact that in the recent past he has lost a lot of blood or underwent abdominal surgery, then he is at risk of getting blood poisoning. The worse the patient’s immune system copes with its functions, the higher the likelihood that pathogenic bacteria will not be localized in only one organ, but will spread through the bloodstream throughout his body.

If we talk about specific reasons that provoke the development of sepsis in a patient, then these may include:

• penetration of infection from the outside due to violation of the integrity of the skin and other tissues of the body – for example, setting droppers, all kinds of surgical interventions, etc.;
• spread of infection throughout the body from purulent inflammations – boils, carbuncles, etc.;
• various infectious diseases of the urinary tract, etc.

It makes sense to mention separately how high the risk of signs of blood poisoning after an abortion or childbirth is: in this case, pathogens “introduce” into the woman’s body through the mucous membrane lining the uterus from the inside. It is for this reason that the death rate of women due to clandestine abortions was so high in those years when abortion was not yet a legal procedure.

Symptoms of blood poisoning

Regardless of the activity of which pathogenic microorganism provoked the development of sepsis, the symptoms of blood poisoning are always the same:

• weakness, loss of working capacity;
• loss of appetite up to its complete disappearance;
• chills, fever;
• headache;
• palpitations;
• lowering blood pressure;
• shortness of breath, etc.

Signs of blood poisoning are gradually increasing – the patient may gradually develop renal, cardiac, respiratory and other types of insufficiency. A blood test reveals an increased concentration of white blood cells in it and a sharply increased ESR.

Detection and treatment of blood poisoning

Diagnosis of this pathology, in addition to determining the patient’s signs of blood infection, provides for all kinds of measures to identify infectious agents in the blood, as well as to detect foci of infection in various tissues and organs.