Department of Intensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, Australia.
School of Clinical Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia.
Expert Rev Anti Infect Ther. 2022 Sep;20(9):1171-1178. doi: 10.1080/14787210.2022.2099375. Epub 2022 Jul 17.
Older individuals (i.e. age ≥65 years) are at increased risk for development of infections including those due to antimicrobial-resistant bacteria, and transmission may occur between institutional and community settings.
This article reviews infections in older individuals with a specific focus on healthcare-related and antimicrobial resistant infections. A structured narrative review was performed to identify articles published in English since 2010. Themes included defining the scope of the problem, establishing characteristics of older individuals that impact the burden of resistant infections, and interventions aimed at minimizing their impact.
Older individuals suffer a high burden of illness related to antimicrobial resistant infections. Individuals with chronic illnesses, frailty, and residents of nursing homes are at highest risk. Clinical trials have shown that antimicrobial stewardship interventions may reduce antibiotic use in nursing homes without compromising safety. Antimicrobial resistant bacteria are prevalent among nursing home residents, and bundled infection prevention and control interventions can reduce their transmission. Transmission of antimicrobial resistant bacteria occurs among older adults across hospital and institutional settings, which may further spread to the community. The burden of infections in older adults is expected to increase in the coming years and represents a healthcare and research priority.
老年人（即年龄≥65 岁）发生感染的风险增加，包括由抗菌药物耐药菌引起的感染，并且在医疗机构和社区环境之间可能发生传播。
本文主要综述了老年人的感染问题，特别关注与医疗保健相关和抗菌药物耐药的感染。通过结构化的叙述性综述，确定了自 2010 年以来以英文发表的文章。主题包括确定问题的范围、确定影响耐药感染负担的老年人特征，以及旨在最小化其影响的干预措施。
老年人对抗菌药物耐药感染的疾病负担很高。患有慢性病、身体虚弱和居住在养老院的人风险最高。临床试验表明，抗菌药物管理干预措施可以减少养老院的抗生素使用，而不会影响安全性。养老院居民中普遍存在抗菌药物耐药菌，并且综合感染预防和控制干预措施可以减少其传播。抗菌药物耐药菌在医院和医疗机构的老年人之间传播，这可能会进一步传播到社区。预计未来几年老年人感染的负担将会增加，这是医疗保健和研究的重点。
