Mayanka A.1, Vasanthan K.2, Vengadakrishnan K.3, Sudagar Singh R.B.4, Senthil N.5
BACKGROUND
Elderly people have increased susceptibility to infection and are at significantly
increased risk of morbidity and mortality due to various common infections.
Urinary tract and respiratory tract infections predominate in elderly people. Gram
negative pathogens especially E. coli are commonly observed pathogens. In gram
positive infections, staphylococcus is usually isolated from skin and soft tissue
infections.
METHODS
Data was collected prospectively between the months of March 2015 and August
2016. Patient demographics and clinical data were recorded from oral
questionnaires and hospital records. 219 patients satisfied the inclusion criteria.
All patients were subjected to basic investigations with blood and urine cultures at
the time of admission. Other cultures like respiratory or pus cultures were collected
as and when needed. Specific investigations such as ultrasound abdomen,
computed tomography kidneys, ureters and bladder (CT KUB), CT thorax,
echocardiography, neuroimaging and procalcitonin were done in certain patients
when required.
RESULTS
Of the 219 patients included in this study, 127 (58 %) were males and 92 (42 %)
were females. Mean age of the study population was 72.40. The most common
source of bacteraemia was urinary in 33 % and was unknown in 25 %. The most
common organism isolated in blood culture was Staphylococcus aureus followed
by E. coli. Respiratory infections had unidentified pathogens in 81 % of patients.
The most common organism isolated from respiratory secretions was klebsiella
followed by acinetobacter and pseudomonas. 11 % of patients developed multi
organ dysfunction syndrome of which urinary and respiratory systems were the
most common primary sources of infection.
CONCLUSIONS
A significant incidence of unidentified source of infection was observed.
Staphylococcus bacteraemia was a significant observation as E. coli is reported to
be common. Urinary tract and respiratory infections were seen to be associated
with increased incidence of multiorgan dysfunction.
