Hospital-acquired bloodstream infections in geriatric wards: a retrospective clinical study / 中华老年医学杂志

ABSTRACT

Objective To investigate the clinical and pathogenic features and other related factors of hospital-acquired bloodstream infections (HABSI) in geriatric wards,in order to provide the scientific basis for clinical diagnosis and therapy.Methods Clinical characteristics and other related factors of HABSI in patients admitted to the Department of Geriatrics of our hospital from June 2010 to October 2015 were retrospectively analyzed.Results Of the 64 elderly patients with HABSI,malignant tumor (39.1％) and type 2 diabetes mellitus (32.8％) were among the main disorders for their admission to the hospital.There were 53 cases of primary bloodstream infections and 11 cases of secondary bloodstream infections,accounting for 82.8％ and 17.2％,respectively.Primary infections involved mostly the respiratory,urinary and hepatobiliary systems.13 patients died,giving a fatality rate of 20.3％.Multiple logistic regression analysis showed that the retention time of central venous catheters or implantable venous access ports was ≥ 7 days (OR =49.51) and the duration of proton pump inhibitor administration was ≥3 days (OR=13.63),and these were independent risk factors for HABSI in elderly patients.A total of 66 strains of pathogenic bacteria were detected from the 64 patients.The most common G+ type was coagulase negative staphylococcus (18.2 ％) and the most common G-bacteria were Escherichia coli (18.2％) and Klebsiella pneumonia (15.2％),with the latter two making up 54.5％ of the extended-spectrum β-lactamase (ESBL)-producing strains.Conclusions HABSI can seriously affect the prognosis of elderly patients.Reduction in invasive procedures,active prevention and treatment of tumors,improvement of the internal environment and protection of vital organ functions are the main measures to reduce the bloodstream infection rate in geriatric wards.