요양병원과 연관된 균혈증의 임상양상 및 항균제 내성현황

Abstract

Background: The risk of healthcare-associated infections (HCAI) is increasing, due to the increase in geriatric hospitals. However there has been a lack of studies on HCAI in patients of geriatric hospitals. Hence, we aimed to investigate the epidemiological and microbiological characteristics of geriatric hospital patients who developed bloodstream infections (BSI). Method: Among patients who visited emergency department of a single university hospital between January 2007 and December 2011 and showed BSI, we selected patients transferred from geriatric hospitals by reviewing the medical records. Results: Among a total of 921 patients who visited the emergency department with BSI during the study period, 63 patients (6.84%) were residents at geriatric hospitals. Of these, 53.7% were male, the mean age was 69.8 years, and 73.0% were elderly patients of 65 years or over. Malignant tumor was the most common underlying disease. Urinary tract infection (30.1%) was the most common cause of BSI, and in terms of causative pathogen, there were 34.8% of gram-positive bacteria, 31.3% of gram-negative bacteria, and 17.3% of multiple infection with two or more types of bacteria. Multidrug resistant bacteria were reported in 13.0%, including 8.7% of MRSA infection. In patients with less than the mean length of stay (LOS) (20 days), there was a significant association between appropriate early antibiotics use and mean LOS. Conclusion: Treating BSI in geriatric hospital patients requires appropriate antibiotics treatment taking into account multi- factors, including the pathogen of BSI, antibiotics resistance, the patient’s age. Use of appropriate early antibiotics reduces the mean LOS.