Abstract
ObjectiveThe aim of this study was to determine the prevalence of Neisseria meningitidis, Haemophilus influenzae, Streptococcus pneumoniae, group A Streptococcus (GAS), and Staphylococcus aureus in asymptomatic elderly people and to unravel risk factors leading to colonization.MethodsA multi-centre cross-sectional study was conducted including 677 asymptomatic adults aged 65 years or more, living at home or in nursing homes. Study areas were Greater Aachen (North-Rhine-Westphalia) and Wuerzburg (Bavaria), both regions with medium to high population density. Nasal and oropharyngeal swabs as well as questionnaires were collected from October 2012 to May 2013. Statistical analysis included multiple logistic regression models.ResultsThe carriage rate was 1.9% ([95%CI: 1.0–3.3%]; 13/677) for H. influenzae, 0.3% ([95%CI: 0–1.1%]; 2/677) for N. meningitidis and 0% ([95% CI: 0–0.5%]; 0/677) for S. pneumoniae and GAS. Staphylococcus aureus was harboured by 28.5% of the individuals ([95% CI: 25.1–32.1%]; 193/677) and 0.7% ([95% CI: 0.2–1.7%]; 5/677) were positive for methicillin-resistant S. aureus. Among elderly community-dwellers colonization with S. aureus was significantly associated with higher educational level (adjusted OR: 1.905 [95% CI: 1.248–2.908]; p = 0.003). Among nursing home residents colonization was associated with being married (adjusted OR: 3.367 [1.502–7.546]; p = 0.003).ConclusionThe prevalence of N. meningitidis, H. influenzae, S. pneumoniae and GAS was low among older people in Germany. The S. aureus rate was expectedly high, while MRSA was found in less than 1% of the individuals.
Highlights
The carriage rate was 1.9% ([95%confidence intervals (CI): 1.0–3.3%]; 13/677) for H. influenzae, 0.3% ([95%CI: 0–1.1%]; 2/677) for N. meningitidis and 0% ([95% CI: 0–0.5%]; 0/677) for S. pneumoniae and group A streptococcus (GAS)
Staphylococcus aureus was harboured by 28.5% of the individuals ([95% CI: 25.1–32.1%]; 193/677) and 0.7% ([95% CI: 0.2–1.7%]; 5/677) were positive for methicillinresistant S. aureus
Among elderly community-dwellers colonization with S. aureus was significantly associated with higher educational level
Summary
Invasive infections caused by N. meningitidis, H. influenzae, S. pneumoniae, group A streptococcus (GAS) and S. aureus are an important cause of morbidity and mortality in elderly people. In Germany, the incidence of invasive H. influenzae disease is highest in older people (incidence 2.8/100.000 in persons aged older than 69 years) [6, 7]. The incidence of invasive meningococcal disease is low among older German adults (0.2/100.000), but the rate of septicaemia (65.1%) is highest in this age group [8]. Concerning invasive infections with MRSA, the incidence is highest in individuals aged more than 79 years (13/100.000) and 84% of the cases concern persons aged 60 years or older [7]. Vaccination against H. influenzae serotype b or N. meningitidis is not part of the vaccination schedule for elderly people and is recommended only to risk groups [13]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
