Infections/ Antibiotics and older Adults

Despite advances in antibiotic therapy, infectious diseases continue to be a major cause of mortality in older adults. Ritu Banerjee and her colleagues  at the Mayo Clinic have reported that Antibiotic-resistant Escherichia coli (E. coli ST131) continues to proliferate within hospitals and long-term care facilities. In a study published in found that  LTCF residents having 8 times the risk of contracting E.coli ST131 compared with non-LTCF residents. This trend coincides with the increasing prevalence of ST131 among patients 65 years and older. It is likely that extensive antibiotic exposure, close contact with other antibiotic-exposed individuals, age and health-associated alterations in intestinal microbiota all contribute to the high prevalence of ST131 among the elderly population.  ST131 isolates were also more than twice as likely to be healthcare-associated infections as compared to community-associated infections.

The diagnosis of infection in older adults is more challenging, Only 40 percent of older adults with serious infections develop increased white blood count, and since frail older adults tend to have poorer body temperature response, there might not be an perceptible increase in temperature. Body response to infection, among older adults, are subtle, and nonspecific. Such responses might be change in mental alertness and delirium in half of older adults with infections. In addition, anorexia, functional decline, falls, weight loss or a slight increase in respiratory rate may be the only signs indicating infection in older adults.