Community acquired bacteremia in older adults: International and prospective infectious diseases-international research initiative (ID-IRI) study.
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Sokulmez-Yildirim Sevgi, Erdem Hakan, Ankarali Handan, Senbayrak Seniha, Kartal Elif Doyuk, Bayrak Ozlem, Poojary Aruna, Darazam Ilad Alavi, Sullu Beyza, Tasbakan Meltem, Kahraman Refika Nur, Araz Halime, Atasoy Pinar Yuruk, Roganovic Tatjana, Cetin Sinan, Yekenkurul Dilek, Civljak Rok, Oktay Zeynep, Dogan Ahmet, Okay Gulay, Ramosaco Ergys, Pekok Abdullah Umut, Inan-Sarikaya Rukiye, Miftode Egidia, Kolovani Entela, Amer Fatma, Aksoy Firdevs, Ghasempour Homa, Miftode Larisa, Lengerova Gergana, El-Kholy Amani, Grgic Svjetlana, Petrov Michael Mihailov, Alkan Sevil, Kotsev Stanislav, Peleva Maria Pishmisheva, Sivrikaya Bahar Busra, Ipek Davut, Poposki Kostadin, Lanzafame Massimiliano, Ak Oznur, Yaylaci Selcuk, Altindis Mustafa, Isik Arzu Cennet, Coskun Belgin, Gurbuz Esra, Shehata Ghaydaa A, Kaya Nilgun Koltuk, Bozkurt Ilkay, Imre Ayfer, Tartar Ayse Sagmak, Yildirim Cigdem, Dumitru Irina Magdalena, Catalina Luca Mihaela, Belitova Maya, Taher Omnia Mohamed Elnabawy Ahmed, Sari Sema, Cascio Antonio, Rahimi Bilal Ahmad, Karlidag Gulden Eser, Onofrei Maria Ioana, Al Sevda Ozdemir, Kulzhanova Sholpan, Cag Yasemin, Ucar Hatice Kubra, Ozmen Cumhur, Gherlan George Sebastian, Gad Maha Ali, Akhtar Nasim, Oncu Serkan, Vieceli Tarsila, Konkayev Aidos, Esmaoglu Aliye, Kilavuz Asli, Bucuk Pinar Sirmatel, Szabo Balint Gergely, Davila Christian Gomez, Semet Cihan, Puca Edmond, Evren Emine Unal, Tehrani Hamed Azhdari, Angamuthu Kumar, Sonmezer Meliha Cagla, Soysal Orcun, Ates Selma, Spurio Giulia, Demircan Sultan Keskin, Onder Taylan, Sökmen Fevzi Coskun, Rello Jordi, Giammanco Anna, Fasciana Teresa
Аннотация
METHODS: This prospective, observational study was conducted in 72 referral centers across 16 countries between June 1 and September 1, 2024. Patients aged ≥65 years with confirmed CA-BSI were included. Demographic, clinical, laboratory, and treatment data were collected. The primary outcome was 30-day all-cause mortality. Univariate and multivariate logistic regression was used to identify predictors.
RESULTS: 574 patients were enrolled (median age 74 years; 48.1% female), and 30-day mortality was 26.3%. Urinary tract infection was the most common source (33.7%), and 30.5% had no identifiable origin. Gram-negative organisms predominated (58.6%). Independent mortality predictors included SOFA score ≥5, thrombocytopenia (<50,000/µL), Staphylococcus aureus bacteremia, pneumonia, bacteremia of unknown origin, and higher Charlson Comorbidity Index. Higher Katz Activities of Daily Living scores were protective.
CONCLUSION: CA-BSI in older adults is associated with high mortality. Outcomes are driven by comorbidity burden, functional status, infection severity, and causative pathogen, highlighting the need for early risk stratification and tailored management.