Bloodstream Infections in the Elderly: Effects of Nursing Homes on Antimicrobial-Resistant Bacteria
Resource
Int. J. Gerontol., 6(2), 93-100
Journal
International Journal of Gerontology
Pages
93-100
Date Issued
2012
Date
2012
Author(s)
Huang, Ming-Yuan
Chang, Wen-Han
Hsu, Chen-Yang
Tsai, Weide
Chen, Ying-Jiiin
Lee, Chao-Hsiung
Feng, Yen-Yi
Huang, Shu-Tien
Kung, Lu-Chih
Abstract
Objectives: Emergency room visits by nursing home patients with bloodstream infections (BSIs) are not uncommon and pose challenges to clinicians when selecting appropriate antimicrobial agents. This research aims to discover distinct bacteriology in nursing home patients by focusing particularly on antimicrobial-resistant bacteria.
Methods: This retrospective study enrolled patients aged 65 years or older who had documented positive blood culture reports between May 2006 and June 2008. Patients were further categorized into subgroups according to nursing home history and the timely trend of hospital exposure.
Results: The adjusted risk of BSIs associated with nursing home exposure was significantly higher in Methicillin-resistant Staphylococcus aureus (odds ratio (OR) 2.0; 95% CI 1.5-2.8), Methicillin-resistant coagulase-negative Staphylococcus species (OR 1.7; 95% CI 1.2-2.5), and Enterobacteriaceae-extended spectrum beta-lactamase-producing Enterobacteriaceae (OR 2.4; 95% CI 1.5-3.9), but not in Pseudomonas aeruginosa (OR 1.4; 95% CI 0.9-2.2) or Acinetobacter baumannii (OR 0.9; 95% CI 0.5-1.5).
Conclusion: Host environments-nursing home or hospital exposure-were shown to be more significant than medical comorbid conditions for acquiring antimicrobial-resistant pathogens. Each unique environment increased the risk for acquiring some pathogens, but not all. In addition, these environmental factors may also exert cumulative effects toward some specific pathogens. Copyright (c) 2012, Taiwan Society of Geriatric Emergency & Critical Care Medicine. Published by Elsevier Taiwan LLC. All rights reserved.
Subjects
antibacterial drug resistance
bloodstream infection
nosocomial infections
nursing homes
Other Subjects
Acinetobacter baumannii; aged; antibiotic resistance; article; blood culture; bloodstream infection; comorbidity; extended spectrum beta lactamase producing Enterobacteriaceae; female; geriatrics; hospital infection; human; major clinical study; male; methicillin resistant Staphylococcus aureus; nursing home; priority journal; retrospective study
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