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Evaluation of humoral immune response to nosocomial pathogen and functional status in elderly patients with sepsis.

Authors
 Su Jin Jeong  ;  Sang Sun Yoon  ;  Sang Hoon Han  ;  Dong Eun Yong  ;  Chang Oh Kim  ;  June Myung Kim 
Citation
 Archives of Gerontology and Geriatics, Vol.58(1) : 10-14, 2014 
Journal Title
 Archives of Gerontology and Geriatics 
ISSN
 0167-4943 
Issue Date
2014
MeSH
Activities of Daily Living* ; Aged ; Antibodies, Bacterial/blood ; Antibodies, Bacterial/immunology* ; CD4-CD8 Ratio ; Cause of Death/trends ; Confidence Intervals ; Cross Infection/immunology* ; Cross Infection/mortality ; Cross Infection/physiopathology ; Enzyme-Linked Immunosorbent Assay ; Female ; Follow-Up Studies ; Hospital Mortality/trends ; Humans ; Immunity, Humoral* ; Male ; Odds Ratio ; Prognosis ; Prospective Studies ; Republic of Korea/epidemiology ; Sepsis/immunology* ; Sepsis/mortality ; Sepsis/physiopathology ; T-Lymphocytes/immunology* ; Time Factors
Keywords
Elderly patients ; Functional status ; Humoral immunity ; Risk factors ; Sepsis
Abstract
The clinical significance of humoral immune response to nosocomial pathogens and functional status in elderly patients with sepsis is not clear. We evaluated the humoral immune to nosocomial pathogens and the effect of functional dependencies on clinical outcomes among elderly patients with sepsis. This study prospectively enrolled patients aged ≥65 years with sepsis from September 2011 to May 2012 at a 2000-bed university hospital. The data including CD4 and CD8 T-cell count, functional status by measuring basic activities of daily living (ADL) and instrumental activities of daily living (IADL) were collected for all patients. In addition, the collected blood samples were analyzed for serum antibody levels against nosocomial pathogens using an ELISA. During the study period, 72 patients (38 males) treated with sepsis were enrolled. The all-cause in-hospital mortality rate was 16.7% (12/72). The mean CD4/CD8 T-cell ratio was significantly lower in nonsurvivors than in survivors (1.08 ± 0.72 vs. 1.93 ± 1.42, P = 0.003). Serum antibody titers to Acinetobacter baumannii, Klebsiella pneumonia, Stenotrophomonas maltophilia, and Enterococcus faecalis were statistically higher in nonsurvivors than in survivors. On multivariate analysis, the IADL score was independently predictive of mortality in elderly patients with sepsis (odds ratio 1.410, 95% confidence interval 1.007–1.975, P = 0.046). These results suggest that IADL scores could be used as predictors to identify elderly patients with a poor prognosis of nosocomial infections.
Full Text
http://www.sciencedirect.com/science/article/pii/S0167494313001088
DOI
10.1016/j.archger.2013.07.001
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Microbiology (미생물학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Kim, June Myung(김준명)
Kim, Chang Oh(김창오) ORCID logo https://orcid.org/0000-0002-0773-5443
Yong, Dong Eun(용동은) ORCID logo https://orcid.org/0000-0002-1225-8477
Yoon, Sang Sun(윤상선) ORCID logo https://orcid.org/0000-0003-2979-365X
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
Han, Sang Hoon(한상훈) ORCID logo https://orcid.org/0000-0002-4278-5198
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/97925
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