Factors associated with nosocomial infection in the elderly in the Intensive Care Unit

Abstract

Background: The elderly have increased vulnerability to disease and exposure to hospital infections.

Aims: The study aims to evaluate the clinical and epidemiological factors associated with nosocomial infection in the elderly.

Methods: A retrospective study with a population of 625 elderly patients admitted to intensive care units and a sample of 308 elderly who developed nosocomial infection from January 2012 to June 2015.

Results: A total of 49.7% of the elderly presented a growth of micro-organisms in tracheal aspirates. The diseases classified as "other" increased likelihood of tracheal infection (3.61, 95% - CI 1.84 to 7.10; p = 0.005) and the probability of growth of micro-organism in the culture performed elsewhere - general (8.96, 95% - CI 3.03 to 26.49; p = 0.005). Surgical procedures increased the chance of growth of micro-organisms in tracheal secretion culture (OR 1.96, 95% CI 1.11 to 3.48) and surgical site culture (OR 5.06, 95% CI 1, from 76 to 14.55). The neurological disease increased the chance of growth of micro-organisms in the cultures of tracheal secretions, blood and general (OR 3.80, 95% CI 1.22 to 11.83; OR 3.27, 95% CI 1.24 - 8.66; OR 15.61, 95% CI 4.78 to 50.98). The pneumothorax increases by four times the probability of growth of micro-organisms in the catheter tip (OR 4.17, 95% CI 1.24 to 13.97). Chronic and acute renal failure and other diagnoses increased by eighteen times the chance of growth of micro-organisms in general culture (OR 18.06, 95% CI 3.63 to 89.86).

Conclusion: The main risk factors for nosocomial infection of elderly in the Intensive Care Unit are chronic and acute renal failure, neurological diseases and surgical procedures and must be adopted a policy of prevention and control of nosocomial infection in the treatment of the elderly.

Keywords: Elderly, Cross infection, Intensive care.