Abstract
BackgroundWe analyzed the results of a 3-year surveillance study on the epidemiological and clinical characteristics of healthcare associated-infections (HAIs) in elderly inpatients in a large tertiary hospital in China.MethodsReal-time surveillance was performed from January 1, 2015 to December 31, 2017. All HAIs were identified by infection control practitioners and doctors. Inpatient data were collected with an automatic surveillance system.ResultsA total of 134,637 inpatients including 60,332 (44.8%) elderly ≥60 years were included. The overall incidence of HAI was 2.0%. The incidence of HAI in elderly patients was significantly higher than that in non-elderly patients (2.6% vs. 1.5%, χ2 = 202.421, P < 0.01) and increased with age. The top five sites of HAIs in the elderly were the lower respiratory tract, urinary tract, blood stream, antibiotic-associated diarrhea, and surgical site. The five most common pathogens detected in elderly HAI patients were Candida albicans, Klebsiella pneumonia, Acinetobacter baumannii, Escherichia coli, and Pseudomonas aeruginosa. The incidence of ventilator-associated pneumonia in the elderly was lower than in the non-elderly, catheter-associated urinary tract infections were more common in elderly patients, and the rate of central line-associated bloodstream infection was similar between groups. The numbers of male patients and patients with comorbidities and special medical procedures (e.g., intensive care unit admission, cerebrovascular disease, brain neoplasms, hypertension, hyperlipidemia, diabetes mellitus, coronary artery disease, chronic obstructive pulmonary disease, malignant tumor, malignant hematonosis, and osteoarthropathy) were significantly higher in the elderly group, but the number of patients who underwent surgery was lower.ConclusionWe observed a significantly higher overall incidence of HAI in elderly inpatients ≥60 compared to non-elderly inpatients < 60 years, but the trend was different for device-associated HAIs, which was attributed to the higher rates of comorbidities and special medical procedures in the elderly group. The main HAI sites in elderly inpatients were the lower respiratory tract, urinary tract, and bloodstream, and the main pathogens were gram-negative bacilli and Candida albicans.
Highlights
We analyzed the results of a 3-year surveillance study on the epidemiological and clinical characteristics of healthcare associated-infections (HAIs) in elderly inpatients in a large tertiary hospital in China
There were 1580 HAIs in 60,332 elderly inpatients and 1132 HAIs in 74,305 non-elderly inpatients, with a significantly higher incidence in elderly compared to non-elderly (2.6% vs. 1.5%, χ2 = 202.421, P < 0.001)
The incidence of HAI in elderly inpatients significantly increased with age, with rates of 2.0% (637/ 32,156), 2.5% (462/18,203), and 4.8% (481/9973), respectively in patients aged 60–69 years, 70–79 years and ≥ 80 years (χ2 = 225.960, P < 0.001)
Summary
We analyzed the results of a 3-year surveillance study on the epidemiological and clinical characteristics of healthcare associated-infections (HAIs) in elderly inpatients in a large tertiary hospital in China. In 2017, there were an estimated 962 million people aged ≥60 years in the world, comprising 13% of the global population [1]. The population aged ≥60 is growing at an annual rate of ~ 3%. European countries currently have the greatest percentage of population aged ≥60 (25%). Rapid ageing will soon occur in other parts of the world, and by 2050 all regions except Africa will have nearly a quarter or more of their populations ≥60 [1]. Population ageing is projected to have a profound effect on societies by increasing demand on fiscal, political, healthcare, and social protection systems of many countries in coming decades.
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