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Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
S117
versus 38%, p = 0.99; log-rank test), weight loss, development of
clinical symptoms, bacterial concentrations in cerebellum [7.5
×
10
7
(2
×
10
7
/2.5
×
10
8
) versus 1.1
×
10
8
(6
×
10
7
/7
×
10
8
), p = 0.10] and spleen
[3.5
×
10
5
(6.5
×
10
4
/8.5
×
10
5
) versus 3
×
10
5
(1
×
10
5
/7
×
10
5
), p = 0.89]
as well as the amount of CNS infiltrating leukocytes [1.6(1.2/2)
versus 1.6(1.4/2), p = 0.61] (Mann–Whitney U-test).
Conclusions:
In contrast to results from our geriatric mouse
model of E. coli meningitis, where aged mice showed a higher
mortality and an impaired elimination of bacteria, we did not find
any differences between aged and young mice after intracerebral
infection with S. pneumoniae SP3. This indicates that the increased
susceptibility of aged mice to bacterial CNS infections is pathogen-
specific: It appears less prominent in infections caused by hardly
phagocytable pathogens with thick capsules, like SP3, where the
age-related decline of the phagocytic capacity of microglia and
macrophages has only minor impact.
P-321
Development and validation of Attitudes towards Vaccinations
Scale
K. Szczerbinska
1
, P. Brzyski
1
, A. Prokop
2
, T. Ocetkiewicz
2
1
Epidemiology and Preventive Medicine Chair, Jagiellonian University
Medical College, Krak´ow, Poland;
2
Epidemiology and Preventive
Medicine Chair, Jagiellonian University Medical College, Krak´ow
Objectives:
The aim of the study was to develop and validate the
scale measuring positive and negative attitudes toward vaccinations
among older people aged 60 and more in Poland. According to our
previous research, vaccination rates and general knowledge about
vaccination in this group are low despite of higher risk of serious
effects of communicable diseases among older people.
Methods:
Correlation matrix was analysed for both development
and validation stages separately. Factor structure of the scale
was assessed using Principal Component Analysis (PCA). Assuming
that personality traits, individual beliefs and habitual traits play
significant role in shaping particular attitudes, we compared scores
of ATVS’s subscales with the measurements of the following
variables: anxiety, copying with stress, self-efficacy, health locus
of control, and health behaviours.
Results:
The scores of the positive subscale of ATVS correlated
positively with all subscales of Health-related Behaviours Inventory,
the most strongly with positive attitudes and proper nutrition
habits, as well as with self-rated health, and self-assessment of
risk of catching influenza or pneumonia. Some significant negative
correlations exist between the negative subscale of ATVS, and
both generalized self-efficacy and internalized locus of control.
Moreover, the negative subscale of negative attitudes correlates
negatively with self-rated health and self-assessment of risk of
catching influenza.
Conclusions:
The results support the assumption that the positive
attitude toward vaccinations correlates with pro-health behaviours:
the strongest is for positive attitude and proper nutrition habits.
P-322
Impact of a Legionella outbreak in an elderly population
R. Tourais Martins
1
, B. Ferreira
1
, C. Gra ¸ca
2
, C. Louro
1
, D. da Cruz
1
,
E. Diaz
1
, J. Sim˜oes
1
, J. Neiva
1
, J. Louro
1
, L. Silva
1
, T. Camacho
1
,
Z. Soares
1
, M.J. Alves
1
, E. Doutel Haghighi
1
, J. Barata
1
1
Hospital Vila Franca de Xira, Lisboa, Portugal;
2
Hospital Vila Franca
de Xira, Lisboa
Introduction:
On November 2014, one of the largest outbreaks
of Legionella spp, an agent responsible for community-acquired
pneumonia(CAP), occurred in Vila Franca de Xira – Portugal. Like
in other cases of CAP, the elderly were one of the afflicted.
Methods:
A retrospective observational study of patients with
≥65 years old admitted to our Emergency department(ER) during
the 2014 outbreak with Legionella pneumophila antigen in urine.
Variables: gender; age; residence; comorbidities; intensive care
admission; length of stay; destination after discharge.
Results:
Of the 192 cases received in the ER, 59(30.7%) were aged
≥65 years (7.3% with
>
80 years). Of these, 32 were male, had a
mean age of 73.8 years. 94.9% lived in the area of the outbreak, 3
in a nursing home. 4 were totally dependent and 4 only partially.
84.7% had comorbidities and 13.5% smoked. On admission, 64.4%
had a Pneumonia Severity Index (PSI) of
>
90 and
<
131 and 11.9%
had PSI
>
131. Due to exceeding hospital capacity, 50.8% of patients
were transferred. Of the remaining (29), there was an average stay
of 7.3 days, a mortality rate of 13.8% (4) and 20.7% (6) patients
required intensive care.
When compared with the group with
<
65 years, they had more
comorbidities (84.7% vs 42.2%), smoked less, had less length of stay
(7 vs 8 days), less admissions in ICU and greater mortality rate
(13.8% vs 3.4%).
Conclusion:
Given the small number of Legionella infection cases,
outside of the epidemic context, this outbreak was an opportunity
for a better characterization of the disease.
P-323
Staphylococcus aureus with methicillin-resistant type
infections in the elderly: a real challenge for geriatricians
P. Panek
1
, A. Martin-Kleisch
1
, J.-L. Novella
2
, A.-A. Zulfiqar
1
1
CHU Reims, Reims, France;
2
France
Objectives:
Infections by Gram-positive cocci are encountered in
medical practice, especially in the elderly. Their management is
difficult, due to prolonged antibiotic therapy, not without adverse
effects. Infection by methicillin-resistant character sets to medical
precarious for the elderly.
Methods:
We illustrate our problem in this clinical case.
Results:
A 80-year-old patient, male, is admitted for an unexplained
biological inflammatory syndrome. His medical history includes
peripheral arterial disease of the lower limbs requiring amputation
of his right leg. He has a severe malnutrition. He has, at
his left heel necrotic bedsore without bone contact. His right
stump has purulent sluices. The patient lives in a retirement
home. It is bedridden. It has an indwelling urinary catheter,
the reason is not listed. We perceive a purulent discharge
from the penis; a bacteriological sample is performed. These
samples (right stamp; urethral sample) find an infection caused by
Staphylococcus aureus with methicillin-resistant type. The scanner
of the right stump find suggestive signs of osteitis. The origin
of this infection remains undefined actually. Glycopeptide and
rifampicyne antibiotic therapy is started and will continue for
3 months in the hope of ending this infection. No adverse effects
are detected.
Conclusions:
Staphylococcus aureus with methicillin-resistant type
is a bacterium whose medical care is difficult in the elderly. The
use of repeated doses of antibiotics exposed to multi-resistance
problems; this more problematic in the elderly. Malnutrition
remains a major aggravating factor in the onset of severe infections
in the elderly.