Table of Contents Table of Contents
Previous Page  183 / 290 Next Page
Show Menu
Previous Page 183 / 290 Next Page
Page Background

All-cause and pneumococcal pneumonia rates were highest in asthma

and chronic lung disease patients. IPD rates were highest in chronic

liver and lung disease patients. Per IPD episode, adults with chronic

conditions had slightly more hospital visits and longer length of stay

compared to healthy adults

0.9 vs. 0.8 visits and 7.6 vs 6.6 days

respectively, but substantially higher costs ($12,577 vs. $10,510). IPD

costs were highest in diabetics ($13,357) and heart disease patients



Older adults with chronic conditions are at high risk of

pneumococcal disease, consume more healthcare resources and incur

greater costs.


Low rates of severe injection-site and systemic adverse events

within 7 days postvaccinationwith ZOSTAVAX

, a post hoc analysis

of two pivotal Phase 3 trials

P. Zoran.

Merck & Co., Inc.



, is a single dose live attenuated vaccine

licensed in >50 countries for the prevention of herpes zoster (HZ) and

postherpetic neuralgia (PHN) in adults

50 years-of-age. The objective

of this post-hoc analysis was to determine the rates of severe injection-

site and systemic adverse events (AEs) within 7 days postvaccination

in two pivotal trials, Shingles Prevention Study (SPS) and ZOSTAVAX

Efficacy and Safety Trial (ZEST), utilizing current FDA Toxicity Grading



Injection-site (erythema, swelling, pain) and systemic AEs

were reported by the subject via vaccination report card; SPS n = 6,608;

ZEST n = 22,210. Injection-site erythema and swelling were reported

by size and/or with an intensity category. Severe injection-site and

systemic AEs were defined as incapacitating with inability to work or

do usual activity. The FDA Toxicity Grading Scale was not used in SPS

and ZESTwhich defined severe injection-site (erythema, swelling) and

fever using different scale.


Utilizing FDA Toxicity Grading Scale, severe injection site AEs

(swelling, erythema, pain) occurred in <1.2% of recipients of


within 7 days postvaccination in SPS and ZEST. Higher

rates were observed in recipients of ZOSTAVAX

compared to placebo

and in subjects 50

59 years-of-age. The most frequently reported

severe systemic AE within 7 days postvaccination was headache in


and placebo groups (SPS 0.18% vs 0.18%; ZEST 0.48%

vs 0.38%, respectively). Other severe systemic AEs occurred in <0.2% of

subjects after ZOSTAVAX



Severe injection-site and systemic AEs were reported

infrequently within 7 days postvaccination with ZOSTAVAX

in SPS

and ZEST.


Prolonged suppressive antibiotic therapy for prosthetic joint

infection in patients over 75 years old

V. Prendki


, T. Fraisse


, E. Forestier


, A. Dinh


, G. Gavazzi


, the French

study group on suppressive antibiotic therapy in prosthetic joint



Hôpitaux Universitaires de Genève, Suisse;


Hôpital d



CH Métropole Savoie, Chambéry,


Hôpital Raymond-Poincaré, Garches,


CHU de Grenoble, France


Prolonged suppressive antibiotic therapy (PSAT) is

usually defined as an antibiotic therapy prescribed as a long-life

treatment. Data about PSATare scarce. Our objectivewas to describe its

characteristics and outcomes in PJI in elderly patients.


Using a national retrospective multicentric study, we

analyzed epidemiological characteristics, drug indications, tolerance,

outcomes of a cohort of patients

75 years old and treated with PSAT

for PJI. Event or failure was defined as withdrawal of PSAT, systemic

progression of infection under PSAT and/or death, We used a

composite binary outcome defined as the first occuring event among

these 3 previous type of events.


136 patients had a median age of 84 years {IQR 79


The predominant pathogens among 132 patients with identified

pathogen were staphylococcus (62.1%) (Staphylococcus aureus in

41.7%), enterobacteriacea (15.9%) and streptococcus (15.2%). Initial

intravenous (IV) antibiotic therapy was prescribed for 95 patients

(69.9%). PSAT was prescribed as immediate palliative in 30.1% of cases:

usually with betalactam, cotrimoxazole, fluoroquinolone. First-line

PSAT was stopped in 45 patients (33.1%). 24 patients died (17.6%); 2

were infection-related (8.3%). The median follow-up of patients was 16

months (range 0

112). The 2-year survival rate without event was 70%

(95% confidence interval [CI], 62.5

77.5%). Stepwise backward regres-

sion showed that variables associated with an increased risk of an

event were: monomicrobial infection (HR = 9.15, P = 0.041), a Mac Cabe

score equal to 3 (HR = 2.47, P = 0.054), PSAT given by another person

(HR = 3.39, P = 0.006), bactaeremia (HR = 2.73, P = 0.032). Initial IV

antibiotic therapy was associated with a decreased risk of treatment

failure (HR = 0.43, P = 0.006).


Life-long antibiotic therapy might postpone treatment

failure and may be beneficial in selected cases, in particular in older

patients with limited life expectancy in whom surgery is limb or life-

threatening. Moreover, IV therapy may partially reduce the inoculum

size, facilitating the efficacy of oral PSAT. Large prospective multi-

centric studies, including comprehensive geriatric assessment, are

needed to confirm the place, efficacy and safety of PSAT in PJI and to

homogenize medical practice.


Nosocomial infections urinary tract

C. Ramón-Otero, M. Alcantud, M.A. Areosa, J. Peco, N. Fernández,

M. Asenjo, M. Valdés.

Geriatrics Service of the University Hospital of

Getafe, Madrid, Spain


The main objectives of this study are to describe the

pathogens isolated in urine cultures differentiating between the sexes

in hospitalized patients over 65 years developing nosocomial urinary

tract infection, and analyze the antibiotic resistance of these



Retrospective descriptive study with a sample of 1843 urine

cultures of patients admitted >65 years in the Hospital of Getafe from

2009 to 2015. Using database WASPSS Project.


Between January 2009 and December 2015 1843 urine

cultures were isolated with >100,000 CFU of patients with more

than 72 hours of admission. The isolated pathogens were Escherichia

coli 39.45%, Pseudomonas aeruginosa 15.74%, Enterococcus sp 11.39%

and 10.31% Klebsiella pneumoniae. Differentiating between sexes

Pseudomonas aeruginosa was the second most common pathogen in

men and the fourth in women. E. coli has resistance rate of 0% to

carbapenems, 5% to Fosfomycin and up to 30% to amoxicillin-

clavulanate and levofloxacin. P. aeruginosa has a rate of resistance to

carbapenems (meropenem and imipenem) of 10%, 32% to piperacillin-

tazobactam and 14% to levofloxacin. Enterococcus sp, presents

resistance rates of 0% to Nitrofurantoin, Ampicillin and Vancomycin,

and 55% to Quinolone.


More frequent nosocomial infection pathogens were

related to E. coli, Pseudomonas aeruginosa and Enterococcus sp. High

rate of resistance to recommended clinical guidelines for first-line

treatment antibiotics. Emergence of resistance to broad-spectrum

antibiotics in the last seven years.


Evolution of antibiotic resistance of Escherichia coli in the last

seven years

C. Ramón Otero, M. Alcantud Ibañez, A. Areosa Sastre, J. Peco Torres,

N. Fernández González, M. Asenjo Cambra, M. Valdés Aragonés.

Geriatrics Service, Hospital Universitario de Getafe


Escherichia coli remains being the pathogen most often

implicated in urinary tract infections in elderly patients. The aimof our

study is to describe the evolution and the emergence of antibiotic

resistance from E. coli in the last seven years.

Poster presentations / European Geriatric Medicine 7S1 (2016) S29