Analysis of Geriatric Infections and a Guide to Empirical Antibiotic Therapy

• Published in: Journal of evidence based medicine and healthcare Vol. 8; no. 12; pp. 694 - 698
• Main Authors: A, Mayanka, K, Vasanthan, K, Vengadakrishnan, R.B, Sudagar Singh, N, Senthil
• Format: Journal Article
• Language: English
• Published: 22.03.2021
• DOI: 10.18410/jebmh/2021/136
• ISSN: 2349-2562

BACKGROUND Elderly people have increased susceptibility to infection and are at significantly increased risk of morbidity and mortality due to various common infections. Urinary tract and respiratory tract infections predominate in elderly people. Gram negative pathogens especially E. coli are commonly observed pathogens. In gram positive infections, staphylococcus is usually isolated from skin and soft tissue infections. METHODS Data was collected prospectively between the months of March 2015 and August 2016. Patient demographics and clinical data were recorded from oral questionnaires and hospital records. 219 patients satisfied the inclusion criteria. All patients were subjected to basic investigations with blood and urine cultures at the time of admission. Other cultures like respiratory or pus cultures were collected as and when needed. Specific investigations such as ultrasound abdomen, computed tomography kidneys, ureters and bladder (CT KUB), CT thorax, echocardiography, neuroimaging and procalcitonin were done in certain patients when required. RESULTS Of the 219 patients included in this study, 127 (58 %) were males and 92 (42 %) were females. Mean age of the study population was 72.40. The most common source of bacteraemia was urinary in 33 % and was unknown in 25 %. The most common organism isolated in blood culture was Staphylococcus aureus followed by E. coli. Respiratory infections had unidentified pathogens in 81 % of patients. The most common organism isolated from respiratory secretions was klebsiella followed by acinetobacter and pseudomonas. 11 % of patients developed multi organ dysfunction syndrome of which urinary and respiratory systems were the most common primary sources of infection. CONCLUSIONS A significant incidence of unidentified source of infection was observed. Staphylococcus bacteraemia was a significant observation as E. coli is reported to be common. Urinary tract and respiratory infections were seen to be associated with increased incidence of multiorgan dysfunction. KEYWORDS Elderly, Febrile Illness, Staphylococcus aureus, Escherichia coli, Multiorgan Dysfunction