Clinical correlates of bacteremia in a Veterans Administration extended care facility

J Am Geriatr Soc. 1988 Aug;36(8):726-32. doi: 10.1111/j.1532-5415.1988.tb07175.x.

Abstract

Little is known about bacteremia in long-term care facilities. We have conducted a retrospective study during a 12-month period analyzing the clinical correlates of bacteremia in 533 chronically institutionalized, predominantly male patients, with an average age of 69 years. Thirty-four men had forty-two bacteremic illnesses during this period. The incidence rate was 0.30 episodes per 1000 patient care days, and the mortality rate was 21%. The urinary tract was the most frequently identified tissue source (56%), followed by respiratory tract (7%) and skin (7%). Providencia stuartii was the most common gram-negative organism, while Staphylococcus aureus, Streptococcus pneumoniae and enterococcus were the frequent gram-positive microbes. Gram-negative bacteremia accounted for 63% of the episodes (15% mortality rate), and gram-positive bacteremia accounted for 27% (18% mortality rate); 10% of the bacteremias were polymicrobial (25% mortality rate). Most of the isolated organisms were sensitive to available antimicrobial agents. The leading risk factor for bacteremia was an indwelling urinary catheter (odds ratio 39, 95% confidence limits 16 to 97). Patients with urinary catheters at the beginning of the study constituted only 5% of the population, but accounted for 40% of the gram-negative bacteremias during the year of observation.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Female
  • Gram-Negative Bacteria
  • Gram-Positive Bacteria
  • Humans
  • Institutionalization*
  • Intubation, Gastrointestinal / adverse effects
  • Male
  • Microbial Sensitivity Tests
  • Risk Factors
  • Sepsis / epidemiology*
  • Sepsis / etiology
  • Sepsis / microbiology
  • Sepsis / mortality
  • Skilled Nursing Facilities
  • United States
  • United States Department of Veterans Affairs
  • Urinary Catheterization / adverse effects
  • Urinary Tract Infections / complications
  • Urinary Tract Infections / therapy

Substances

  • Anti-Bacterial Agents