Epidemiology of Bloodstream Infection in Nursing Home Residents: Evaluation in a Large Cohort From Multiple Homes

Clin Infect Dis. 2002 Dec 15;35(12):1484-90. doi: 10.1086/344649. Epub 2002 Dec 2.

Abstract

This study sought to reevaluate the epidemiology of bloodstream infection in nursing home residents. The records of 166 nursing home residents admitted to an urban, public, university-affiliated hospital with 169 episodes of bloodstream infection between January 1997 and April 2000 were retrospectively reviewed. The most common organisms isolated were Escherichia coli (27% of isolates), Staphylococcus aureus (18%; 29% were methicillin-resistant strains), and Proteus mirabilis (13%). There was minimal resistance to quinolones and third-generation cephalosporins among aerobic gram-negative bacilli. The most common sources were the urinary tract (51% of episodes) and the lungs (11%); a source was not identified in 22% of episodes. Hospital mortality was 18%. Independent predictors of hospital mortality were a pulmonary source of infection, systolic blood pressure <90 mm Hg, and leukocytosis >20,000 cells/mm3. Compared with other studies published in the past 2 decades, mortality was lower. The most common resistant organism was methicillin-resistant S. aureus.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Infective Agents / therapeutic use
  • Bacteremia / drug therapy
  • Bacteremia / epidemiology*
  • Bacteremia / microbiology
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Nursing Homes*
  • Retrospective Studies
  • Sepsis / drug therapy
  • Sepsis / epidemiology*
  • Sepsis / microbiology
  • Sepsis / mortality
  • Treatment Outcome

Substances

  • Anti-Infective Agents