Bacteremia in a long-term care facility. Spectrum and mortality.

One hundred episodes of bacteremia were studied in a primarily geriatric population. Gram-positive bacteremia accounted for 24% of all bacteremia (50% mortality rate), while gram-negative bacteremia accounted for 67% of bacteremia (25% mortality); 9% of all bacteremias were polymicrobial in nature (67% mortality). Overall mortality was 35%. The urinary tract was the most frequently identified tissue source (56%) followed by skin and subcutaneous tissue (14%) and respiratory tract (10%). Escherichia coli, Proteus species, and Klebsiella enterobacter group were the most common gram-negative organisms, Staphylococcus aureus was the most common gram-positive organism and together they accounted for approximately 75% of all bacteremia. Fifty percent of deaths occurred within 24 hours of diagnosis of bacteremia, despite appropriate antibiotic therapy. This study may help to identify risk factors for bacteremia in elderly patients.