Eryilmaz-Eren E, et al. Infect Chemother. 2022 Jul;54:e59. https://doi.org/10.3947/ic.2022.0005

To evaluate risk factors affecting the prognosis of sepsis in elderly patients. The study was conducted retrospectively in a secondary healthcare institution between 2016 and 2023. Elderly patients (> 65 years) admitted with sepsis were included. Demographic data, laboratory parameters on the day of diagnosis, sepsis origin, causative microorganisms, and mortality on the 28th day were recorded. A total of 179 elderly patients were included. The median age was 82 and 44% were male. The mortality rate was 49% on the 28th day. Hypertension was more common in the non-survived patients. Blood urea nitrogen (OR 1.03 (1.00-1.05) p = 0.007), and albumin (OR 0.26 (0.10–0.62) p = 0.003), levels were a predictor of mortality at the time of the admission. In the non-survived patients, Systemic inflammatory response syndrome (SIRS) and quick sepsis-related organ failure assessment scores were higher at the time of sepsis diagnosis (p < 0.001). The rate of septic shock (79.5% vs. 33%), intensive care unit (99% vs. 90%), mechanical ventilation (87.5% vs. 55%), and vasopressor needs (55% vs. 27.5%) were significantly higher in the non-survived patients. The rate of bacteremia was found to be higher in the non-survived patient group (26%) than in the survivors (13.2%). The rate of Gram-negative microorganisms was significantly higher in the non-survived patient group than in the survivors (63% vs. 27%; p < 0.001). The most frequently isolated bacteria were Klebsiella pneumoniae (33%) in blood culture; it was Escherichia coli (35%) in urine cultures and Acinetobacter baumanii (40%) in sputum cultures. On the 3-5th day of treatment, the clinical response rate was lower in the non-survived patient group (29%) than in the surviving’s (53%) (p = 0.001). The most important determinants for the mortality were hypertension (OR 2.39 (1.25–4.95) p = 0.019), SIRS score (OR 1.86 (1.32–2.61) p < 0.001) and Gram-negative bacteria sepsis (OR 2.53 (1.22–5.22), p = 0.012). The number and the proportion of the elderly population is increasing worldwide, and sepsis is one of the most common causes of death in elderly patients. Knowing the poor prognostic factors is important for early treatment and to reduce mortality.

Background: The study aimed to investigate the changes in nosocomial infection density after patients were transferred to the intensive care unit (ICU) of a new-build hospital. Methods: The types and rates of nosocomial infections were obtained for a one-year period retrospectively before leaving the old hospital premises and for a one-year periods after moving into the new hospital. The intensive care unit in the “old” premises was comprised of a 17-bedded hall, and thirty-three nurses shifted to work forty-eight hours a week, with each nurse assigned to provide care for two patients. The intensive care unit in the “new” premises consisted of single rooms, each with twenty-eight beds. Results: The median nosocomial infection density decreased from 23 to 15 per 1000 in-patient days. The catheter-related urinary tract infection rate decreased from 7.5 to 2.6 per100 catheter days. Conclusions: Treatment of patients in the new hospital resulted in a decrease in nosocomial infection density.