Mouton C P, Bazaldua O V, Pierce B, Espino D V
The University of Texas Health Science Center at San Antonio, 78284-7795, USA.
Am Fam Physician. 2001 Jan 15;63(2):257-68.
Infectious diseases account for one third of all deaths in people 65 years and older. Early detection is more difficult in the elderly because the typical signs and symptoms, such as fever and leukocytosis, are frequently absent. A change in mental status or decline in function may be the only presenting problem in an older patient with an infection. An estimated 90 percent of deaths resulting from pneumonia occur in people 65 years and older. Mortality resulting from influenza also occurs primarily in the elderly. Urinary tract infections are the most common cause of bacteremia in older adults. Asymptomatic bacteriuria occurs frequently in the elderly; however, antibiotic treatment does not appear to be efficacious. The recent rise of antibiotic-resistant bacteria (e.g., methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococcus) is a particular problem in the elderly because they are exposed to infections at higher rates in hospital and institutional settings. Treatment of colonization and active infection is problematic; strict adherence to hygiene practices is necessary to prevent the spread of resistant organisms.
传染病占65岁及以上人群所有死亡人数的三分之一。在老年人中早期检测更加困难，因为诸如发热和白细胞增多等典型体征和症状常常不存在。精神状态改变或功能衰退可能是老年感染患者唯一的就诊问题。据估计，90%的肺炎所致死亡发生在65岁及以上人群中。流感导致的死亡也主要发生在老年人中。尿路感染是老年人菌血症最常见的病因。无症状菌尿在老年人中频繁发生；然而，抗生素治疗似乎并无效果。近期耐药菌（如耐甲氧西林金黄色葡萄球菌和耐万古霉素肠球菌）的增多在老年人中是一个特别的问题，因为他们在医院和机构环境中接触感染的几率更高。定植和活动性感染的治疗存在问题；严格遵守卫生习惯对于防止耐药菌传播是必要的。
