Systemic inflammatory response syndrome in nosocomial bloodstream infections with Pseudomonas aeruginosa and Enterococcus species: Comparison of elderly and nonelderly patients

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dc.contributor.authorMarra, A. R.
dc.contributor.authorBar, K.
dc.contributor.authorBearman, GML
dc.contributor.authorWenzel, R. P.
dc.contributor.authorEdmond, M. B.
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionVirginia Commonwealth Univ
dc.date.accessioned2016-01-24T12:41:10Z
dc.date.available2016-01-24T12:41:10Z
dc.date.issued2006-05-01
dc.description.abstractOBJECTIVES: To determine whether the systemic inflammatory response syndrome (SIRS), clinical course, and outcome of monomicrobial nosocomial bloodstream infection (BSI) due to Pseudomonas aeruginosa or Enterococcus spp. is different in elderly patients than in younger patients.DESIGN: Historical cohort study.SETTING: An 820-bed tertiary care facility.PARTICIPANTS: One hundred twenty-seven adults with P. aeruginosa or enterococcal BSI.MEASUREMENTS: SIRS scores were determined 2 days before the first positive blood culture through 14 days afterwards. Elderly patients (>= 65, n = 37) were compared with nonelderly patients (< 65, n = 90). Variables significant for predicting mortality in univariate analysis were entered into a logistic regression model.RESULTS: No difference in SIRS was detected between the two groups. No significant difference was noted in the incidence of organ failure, 7-day mortality, or overall mortality between the two groups. Univariate analysis revealed that Acute Physiology and Chronic Health Evaluation (APACHE) II score of 15 or greater at BSI onset; adjusted APACHE II score (points for age excluded) of 15 or greater at BSI onset; and respiratory, cardiovascular, renal, hematological, and hepatic failure were predictors of mortality. Age, sex, use of empirical antimicrobial therapy, and infection with imipenem-resistant P. aeruginosa or vancomycin-resistant enterococci did not predict mortality. Multivarlate analysis revealed that hematological failure (odds ratio (OR) = 8.1, 95% confidence interval (CI) = 2.78-23.47), cardiovascular failure (OR = 4.7, 95% Cl = 1.69-13.1.0), and adjusted APACHE 11 >= 15 at BSI onset (OR = 3.1, 95% CI = 1.12-8.81) independently predicted death.CONCLUSION: Elderly patients did not differ from nonelderly patients with respect to severity of illness before or at the time of BSI. Elderly patients with pseudomonal or enterococcal BSIs did not have a greater mortality than nonelderly patients.en
dc.description.affiliationUniversidade Federal de São Paulo, Hosp São Paulo, Div Infect Dis, São Paulo, Brazil
dc.description.affiliationVirginia Commonwealth Univ, Med Coll Virginia, Dept Internal Med, Richmond, VA 23298 USA
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Hosp São Paulo, Div Infect Dis, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent804-808
dc.identifierhttp://dx.doi.org/10.1111/j.1532-5415.2006.00698.x
dc.identifier.citationJournal of the American Geriatrics Society. Oxford: Blackwell Publishing, v. 54, n. 5, p. 804-808, 2006.
dc.identifier.doi10.1111/j.1532-5415.2006.00698.x
dc.identifier.issn0002-8614
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/28904
dc.identifier.wosWOS:000237531900011
dc.language.isoeng
dc.publisherBlackwell Publishing
dc.relation.ispartofJournal of the American Geriatrics Society
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectelderly patientsen
dc.subjectSIRSen
dc.subjectbloodstream infectionen
dc.subjectPseudomonas aeruginosaen
dc.subjectEnterococcus spp.en
dc.titleSystemic inflammatory response syndrome in nosocomial bloodstream infections with Pseudomonas aeruginosa and Enterococcus species: Comparison of elderly and nonelderly patientsen
dc.typeinfo:eu-repo/semantics/article
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