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Clinical outcomes and epidemiological characteristics of bacteremia in the older Japanese population.
- Source :
-
Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy [J Infect Chemother] 2023 Oct; Vol. 29 (10), pp. 971-977. Date of Electronic Publication: 2023 Jun 22. - Publication Year :
- 2023
-
Abstract
- Background: The characteristics and clinical consequences of bacteremia in older people, who are highly susceptible to infections, need to be clarified. This study aimed to determine the epidemiological characteristics, prognosis, and predictors of 7-day mortality in patients with community-acquired (CA), healthcare-associated (HCA), and hospital-onset (HO) bacteremia in older adults aged ≥65 years.<br />Methods: Patients aged ≥65 years with positive blood cultures between April 1, 2015, and March 31, 2018, were divided into three groups: pre-old (65-74 years), old (75-89 years), and super-old (≥90 years). Characteristics based on medical exposure, including CA, HCA, and HO, were also compared and factors related to mortality were identified.<br />Results: Overall, 1716 episodes of bacteremia were identified in 1415 patients. Of the 1211 episodes without contamination, 32.8%, 54.3%, and 12.9% occurred in pre-old, old, and super-old patients. Central line-associated bloodstream infections were more common in pre-old patients and urinary tract infections in the old and super-old. The 7-day mortality rates in the pre-old, old, and super-old groups were 7.4%, 5.8%, and 14.2% (P = 0.002), respectively. Multivariable logistic regression showed that super-old age (adjusted odds ratio, aOR: 2.09 [1.13-3.88], P = 0.019) and HO bacteremia (aOR: 1.97 [1.18-3.28], P = 0.010) were independent risk factors for 7-day mortality. Infectious disease consultation had a protective effect on 7-day mortality (aOR: 0.59 [0.35-0.99], P = 0.047).<br />Conclusions: The epidemiology of bacteremia differs among older people; thus, they should not be treated as a single entity. A careful approach is needed for the optimal management of bacteremia in these vulnerable patients.<br />Competing Interests: Declaration of competing interest Kei Yamamoto received research grants from Fujirebio, Inc. and Mizuho Medy, Co., Ltd., VisGene, Co., Ltd., Sanyo Chemical Industries Co., Ltd., and Canon Medical Systems Co., Ltd., outside the submitted work.<br /> (Copyright © 2023 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Aged
Humans
East Asian People
Prognosis
Retrospective Studies
Risk Factors
Aged, 80 and over
Japan epidemiology
Bacteremia drug therapy
Bacteremia epidemiology
Bacteremia etiology
Bacteremia mortality
Community-Acquired Infections drug therapy
Community-Acquired Infections epidemiology
Community-Acquired Infections mortality
Cross Infection drug therapy
Cross Infection epidemiology
Cross Infection mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1437-7780
- Volume :
- 29
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy
- Publication Type :
- Academic Journal
- Accession number :
- 37355094
- Full Text :
- https://doi.org/10.1016/j.jiac.2023.06.015