[Community-acquired bacteremic pneumonia in the elderly].

OBJECTIVE: To assess the risk factors associated with the development of bacteremic community-acquired pneumonia in the elderly (BCPE) and its clinical and prognostic aspects. METHODS: We studied 36 BCPE and 72 patients with community-acquired pneumonia and negative blood cultures as control group. RESULTS: The presence of the following risk factors was more common in cases than in control subjects: alcoholism, malnutrition, diabetes and chronic renal insufficiency. The multivariate analysis demonstrated that the malnutrition (OR:3.3; CI95%:1.4-7.8) and diabetes (OR:2.5; CI95%:1.1-6.7) were independent risk factors significantly related to the development of BCPE. The presence of chills, tachycardia, tachypnea, decreased level of consciousness and hypotension blood pressure were more common in case subjects. The microbial agents implicated more frequently were S. pneumoniae and gram-negative bacilli. The bilateral involvement and two or more affected lobes on chest radiograph were more common in the cases of BCPE. The mortality rate was higher in case subjects (22.2% vs. 2.8%; p = 0.001). CONCLUSIONS: We stress the relevance of the bacteremia as prognostic factor in the community-acquired pneumonia in the elderly.