Evaluation of infections in geriatric patients at intensive care unit

Abstract

Background: Infection is a major problem among hospitalized geriatric patients due to reduced immune functions and comorbidities. The course of infections seen in this group are more serious than young people. Duration of hospitalization, morbidity and mortality rates are high. The aim of this study is to evaluate geriatric infections and infection agents in geriatric patients. Methods & Materials: The study was performed in January 2012–December 2012 for one year at Izmir Tepecik Education and Research Hospital. Infections and causative agents among hospitalized patients over 65 years old at Anaesthesiology and Reanimation Intensive Care Unit were evaluated, retrospectively. Data of the patients was achieved from the infection control comitee records. Results: A total of 294 patients were followed-up at intensive care unit during study period. One hundred and seventy six patients (60.8%) who were over 65 years old, enrolled into the study. Infection was detected in 77 (43.7%) of the geriatric patients. The most common infection was ventilatory associated pneumonia (68.8%), following urinary tract infection (32.4%), primary bacteremia (31.3%), catheter related bacteremia (11.6%), pneumonia (6.4%) and skin and soft tissue infections (5.1%). In deep tracheal aspirate cultures, 104 microorganism were isolated. The most common isolated microorganisms were A. baumannii (39.4%) and P. aeruginosa (28.8%). In 35 positive urine cultures, E.coli and P. aeruginosa were both the most prevalent bacterias (20%). The most common primary bacteremia agents were coagulase negative staphylococci (26.9%), A. baumannii (19.2%), E. faecium (15.3%). A. baumannii (30%) was the major cause of catheter related bacteremia. Sputum culture yielded P. aeruginosa (54.5%) and A. baumannii (27.2%) mostly in patient with pneumonia. Tissue biopsy cultures revealed seven (42.8%) isolates of K. pneumoniae. Conclusion: Hospital-acquired infections are major health problem in geriatric patients especially in intensive care units. Cause of infections are predominantly polymicrobial resistant agents such as A. baumannii and P. aeruginosa. Judicious use of antibiotics, limitation of invasive instruments, applying infection control measures can reduce the morbidity and mortality due to infections