Turkish Journal of Geriatrics 2018 , Vol 21, Issue 2
DIFFERENCES IN CLINICAL FEATURES, ETIOLOGY, TYPES, AND RISK FACTORS FOR COMPLICATIONS BETWEEN YOUNG AND OLDER PATIENTS WITH SKIN AND SOFT TISSUE INFECTIONS
Emre HORUZ1, Hande AYDEMİR2, Nihal PİŞKİN2, Deniz ATAKENT3, Güven ÇELEBİ2, Furuzan KÖKTÜRK4
1Zonguldak Maternity and Children Hospital, Infectious Diseases and Clinical Microbiology, Zonguldak, Turkey
2Bülent Ecevit University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Zonguldak, Turkey
3Ufuk University, Dr. Rıdvan Ege Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
4Bülent Ecevit University, Faculty of Medicine, Department of Biostatistics, Zonguldak, Turkey
DOI : 10.31086/tjgeri.2018240425 Introduction: This study investigated differences in clinical features, types, etiology, and risk factors for complications between young and older patients with skin and soft tissue infections. Futhermore, age-related differences in healthcare-associated and complicated infections were identified.

Materials and Method: This retrospective study included 206 skin and soft tissue infection patients hospitalized during an 8-year period. Data were collected using a form: patients" characteristics, clinical features, laboratory values, prior antibiotic use, causative microorganisms, and antibiotic treatment. For cases with clinically diagnosed, samples were taken from the suspected infection sites. Gram staining, deep swab, deep tissue and blood culture results were evaluated.

Results: The incidence of diabetes mellitus was significantly higher among patients aged ?65 years. Among these old patients, Escherichia coli (11/31, 35.5%) and Pseudomonas aeruginosa (8/31, 25.8%) were the most frequently isolated pathogens. Approximately half of the Staphylococcus aureus and Staphylococcus epidermidis strains isolated from patients with health care-associated infection were resistant to methicillin (8/15, 53.3%), and these patients produced higher levels of extended-spectrum beta-lactamase. Venous insufficiency (p=0.008) and prior hospitalization (p=0.001) were identified as risk factors for complication in patients aged ?65. The median time- to -clinical response was 7 days in older patients with non-complicated infection (p=0.007).

Conclusion: Diabetes mellitus was the most common co-morbid factor in older patients. Risk factors for complication may differ by age. Gram-negative pathogens were more commonly isolated in older patients. The time- to -clinical response was significantly longer in older patients with non-complicated infection than young patients. Keywords : Cellulitis; Diabetic foot; Aged; Cross Infection; Risk factors