COMMUNITY ACQUIRED BACTEREMIA IN OLDER ADULTS: INTERNATIONAL AND PROSPECTIVE INFECTIOUS DISEASES-INTERNATIONAL RESEARCH INITIATIVE (ID-IRI) STUDY

OBJECTIVES: Community-acquired bloodstream infections (CA-BSIs) are a major cause of mortality in older adults, yet prospective international data are limited. This study evaluated clinical features, microbiology, and mortality predictors in older patients with CA-BSI. METHODS: This prospective, observational study was conducted in 72 referral centers across 16 countries between June 1 and September 1, 2024. Patients aged ≥65 years with confirmed CA-BSI were included. Demographic, clinical, laboratory, and treatment data were collected. The primary outcome was 30-day all-cause mortality. Univariate and multivariate logistic regression was used to identify predictors. RESULTS: 574 patients were enrolled (median age 74 years; 48.1% female), and 30-day mortality was 26.3%. Urinary tract infection was the most common source (33.7%), and 30.5% % had no identifiable origin. Gram-negative organisms predominated (58.6%). Independent mortality predictors included SOFA score ≥5, thrombocytopenia (<50,000/µL), Staphylococcus aureus bacteremia, pneumonia, bacteremia of unknown origin, and higher Charlson Comorbidity Index. Higher Katz Activities of Daily Living scores were protective. CONCLUSIONS: CA-BSI in older adults is associated with high mortality. Outcomes are driven by comorbidity burden, functional status, infection severity, and causative pathogen, highlighting the need for early risk stratification and tailored management.

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Journal
International Journal of Infectious Diseases
Published
2026-05-01
DOI
https://doi.org/10.1016/j.ijid.2026.108767
Primary Topic
Urinary Tract Infections Management
Type
article
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article

COMMUNITY ACQUIRED BACTEREMIA IN OLDER ADULTS: INTERNATIONAL AND PROSPECTIVE INFECTIOUS DISEASES-INTERNATIONAL RESEARCH INITIATIVE (ID-IRI) STUDY

A. Poojary, Entela Kolovani, Omnia Mohamed Elnabawy Ahmed Taher, Irina Magdalena Dumitru et al.
International Journal of Infectious Diseases
Urinary Tract Infections Management
article

COMMUNITY ACQUIRED BACTEREMIA IN OLDER ADULTS: INTERNATIONAL AND PROSPECTIVE INFECTIOUS DISEASES-INTERNATIONAL RESEARCH INITIATIVE (ID-IRI) STUDY

A. Poojary, Entela Kolovani, Omnia Mohamed Elnabawy Ahmed Taher, Irina Magdalena Dumitru, Maria Ioana Onofrei, Tatjana Roganović, Halime Araz, Elif Doyuk Kartal, Michael M. Petrov, Cihan Semet, Ghaydaa A. SHEHATA, Ayfer İmre, Sultan Keskin Demircan, Hatice Kübra Uçar, Rok Čivljak, Edmond Puca, Гергана Ленгерова, Sinan Çetin, Sema Sarı, Ilad Alavi Darazam, Ergys Ramosaço, Svjetlana Grgić, M. Belitova, Massimiliano Lanzafame, Gülden Eser Karlıdağ, Anna Giammanco, Taylan ÖNDER, Sevgi Sökülmez-Yildirim, Emine Ünal Evren, Belgin Coşkun, Kostadin Poposki, Arzu Cennet Işık, Bálint Gergely Szabó, Hamed Azhdari Tehrani, Yasemin Çağ, İlkay Bozkurt, Ç Yildirim, Tarsila Vieceli, Firdevs Aksoy, Maha Ali Gad, Aliye Esmaoğlu, Fatma Amer, Hakan Erdem, Larisa Miftode, Gülay Okay, Dilek YEKENKURUL, George Sebastian Gherlan, Abdullah Umut Pekok, Cumhur Özmen, Bilal Ahmad Rahimi, Pinar SIRMATEL BUCUK, Kumar Angamuthu, Orçun Soysal, Pınar Yürük Atasoy, Selma Ateş, Luca Mihaela Catalina, Amani El-Kholy, BEYZA SÜLLÜ, Teresa Fasciana, Davut Ipek, Nilgun Koltuk Kaya, Fevzi Coskun Sökmen, Serkan Oncu, Jordi Rello, Esra Gurbuz, Zeynep Oktay, Ahmet Dogan, Homa Ghasempour, Sevda Ozdemir Al, Ozlem Bayrak, Sholpan Kulzhanova, Stanislav Kotsev, Seniha Senbayrak, Christian Gomez Davila, Ayse Sagmak Tartar, Handan Ankarali, Mustafa Altindis, Oznur Ak, Rukiye Inan-Sarikaya, Nasim Akhtar, Maria Pishmisheva Peleva, Bahar Busra Sivrikaya, Asli Kilavuz, Selcuk Yaylaci, Aidos Konkayev, Egidia Miftode, Giulia Spurio, Antonio Cascio, Refika Nur Kahraman, Meliha Cagla Sonmezer, Meltem Tasbakan, Sevil Alkan
article en

Abstract

OBJECTIVES: Community-acquired bloodstream infections (CA-BSIs) are a major cause of mortality in older adults, yet prospective international data are limited. This study evaluated clinical features, microbiology, and mortality predictors in older patients with CA-BSI. METHODS: This prospective, observational study was conducted in 72 referral centers across 16 countries between June 1 and September 1, 2024. Patients aged ≥65 years with confirmed CA-BSI were included. Demographic, clinical, laboratory, and treatment data were collected. The primary outcome was 30-day all-cause mortality. Univariate and multivariate logistic regression was used to identify predictors. RESULTS: 574 patients were enrolled (median age 74 years; 48.1% female), and 30-day mortality was 26.3%. Urinary tract infection was the most common source (33.7%), and 30.5% % had no identifiable origin. Gram-negative organisms predominated (58.6%). Independent mortality predictors included SOFA score ≥5, thrombocytopenia (<50,000/µL), Staphylococcus aureus bacteremia, pneumonia, bacteremia of unknown origin, and higher Charlson Comorbidity Index. Higher Katz Activities of Daily Living scores were protective. CONCLUSIONS: CA-BSI in older adults is associated with high mortality. Outcomes are driven by comorbidity burden, functional status, infection severity, and causative pathogen, highlighting the need for early risk stratification and tailored management.

International Journal of Infectious Diseases
Sakarya University (TR), Ain Shams University (EG), Çanakkale Onsekiz Mart Üniversitesi (TR), Ministry of Health (TR), Cairo University (EG), Giresun University (TR), University of Turku (FI), Ovidius University (RO), Karadeniz Technical University (TR), Bilkent University (TR), University of Health Science (KH), University of Banja Luka (BA), Bursa Technical University (TR), Zagazig University (EG), University of Trento (IT), Niğde Ömer Halisdemir Üniversitesi (TR), Mardin Artuklu University (TR), Ondokuz Mayıs University (TR), University Clinical Hospital Mostar (BA), Clinical Emergency Hospital Bucharest (RO), Mother Teresa Hospital (AL), Breach Candy Hospital (IN), Medical University Plovdiv (BG), Queen Giovanna Hospital (BG), State Hospital (GB), Kütahya Dumlupınar Üniversitesi (TR), Bezmiâlem Vakıf Üniversitesi (TR), Kandahar University (AF), Ege University (TR), Ospedale Santa Chiara (IT), Faculdade Redentor (BR), Canakkale Onsekiz Mart Universitesi Tip Fakultesi Hastanesi (TR), Vall d'Hebron Institut de Recerca (ES), Dr Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi (TR), National Medical Holding (KZ), Samsun University (TR), Sakarya Eğitim ve Araştırma Hastanesi (TR), Erzurum Regional Training and Research Hospital (TR), Education Training And Research (US), Haydarpaşa Numune Eğitim ve Araştırma Hastanesi (TR), Sağlık Bilimleri Üniversitesi (TR), Universidad Privada Boliviana (BO), University Hospital for Infectious Diseases "Dr Fran Mihaljevic" (HR), Spitalul Clinic Dr. Victor Babes (RO), Astana Medical University (KZ), PHI University Psychiatric Clinic - Skopje (MK), Elazığ Eğitim ve Araştırma Hastanesi (TR), National Center for Epidemiology (HU), University clinical center of Republika Srpska (BA), Dammam Central Hospital (SA), University of Kyrenia (CY), Mustafa Kemal University (TR), Kahramanmaraş Sütçü İmam University (TR), Pakistan Institute of Medical Sciences (PK), Eskişehir Osmangazi University (TR), Düzce Üniversitesi (TR), Istanbul Medeniyet University (TR), Shahid Beheshti University of Medical Sciences (IR), Hacettepe University (TR), Istanbul University (TR), Adnan Menderes University (TR), Bolu Abant İzzet Baysal University (TR), University of Health Sciences Antigua (AG), Erciyes University (TR), University of Palermo (IT), Assiut University (EG)
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Urinary Tract Infections Management
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