Bacteremia in a Long Term Care Facility

Abstract

Episodes of bacteremia identified in a long term care facility over a seven and a half-year period from July 1984 to December 1991 were reviewed. Twenty-nine episodes of bacteremia were identified, a rate of 4.35/100,000 patient-days. The most common infecting organisms wereEscherichia coli(11 episodes),Streptococcus pneumoniae(four),Proteus mirabilis(three),Staphylococcus aureus(three) andBacteroidesspecies (two). The source of bacteremia was urinary in 45% of patients, gastrointestinal in 17%, pneumonia in 14%, skin in 14% and unknown in 10%. The overall case fatality rate was 24%, but for the final six years of the review the case fatality rate was only 9.5%. These observations report a rate of bacteremia 10-fold lower than reported from other North American long term care facilities and, potentially, a lower case fatality rate. The primary site of bacteremia, however, in long term care facilities is the urinary tract.