INFECTION AND AGING Why we should invest in Diagnostic Microbiology ?

1. INFECTION AND AGING
Why we should invest in Diagnostic Microbiology
Dr.T.V.Rao MD
I was just reading an article in The Hindu dated 7th October on changing needs of the elderly in
relation to technology, with a tittle AGING WORKERS AND THE NEED FOR NEW TECHNOLOGY. Never
forget the most important factor which hamper the quality of life IN ELDERLY INCLUDE raising
dependence on treatments ASSOCIATED WITH MANY AGE RELATED PROBLEMS however Infection
continues to play the major role in decreeing the quality of life. Now the Average life expectancy
throughout developed countries has rapidly increased during the later half of the 20th century and
geriatric infectious diseases have become an increasingly important issue. Infections in the elderly
are not only more frequent and more severe, but they also have distinct features with respect to
clinical presentation, laboratory results, microbial epidemiology, treatment, and infection control. As
well as a large number of age-associated physiological and anatomical alterations. Moreover, aging
may be the cause of infection but infection can also be the cause of aging. Mechanisms may include
enhanced inflammation, pathogen-dependent tissue destruction, or accelerated cellular aging
through increased turnover. India is in the middle of many matters between developed and
developed nations we can be employable for longer than we imagined in the past, However with rise
of Diabetic incidences we are all prone to many trivial infections which can reduce the quality of life.
However Western countries are facing many ethical issues in relation to even the Infectious diseases
as in palliative care situations and in patients with terminal dementia, the decision whether or not to
treat an infectious disease is becoming a difficult ethical issue. Infections in elderly patients are a
major medical problem. After a period of neglect, this problem is now receiving the deserved
attention of the medical community. Specific manifestations of infectious diseases in the elderly
population are addressed by several reports in the “Aging and Infectious Diseases” section of Clinical
Infectious Diseases. In developing countries, different types of pathogens are encountered, poverty
and malnutrition lead to amplified severity of commonly encountered infections, transmission of
pathogens is increased as a results of deficient infrastructure (e.g., water supply, sewage system,
and hospital hygiene), and there is a lack of resources to treat the specific medical needs of elderly
patients. Thus, the problems associated with infections in elderly patients and their impact on the
medical and socioeconomic systems in developing countries need a specific assessment. If you make
a analysis in terminal illness most of the resources of the patients will drain on Antibiotics. Common
infections in the elderly population. In industrialized countries, pneumonia, urinary tract infections,
and skin and soft-tissue infections are the most relevant infections in elderly patients. In developing
countries, the incidence of these infections is comparably high. Thus, tropical infections do not
replace common infections in the developing world but are superimposed on the infectious
problems that are seen in elderly individuals in the industrialized world. In developing countries,
pneumonia is one of the leading causes of death in elderly patients those >60 years of age.
Numerous studies from developing countries show increasing rates of bacterial resistance. If you
systematically the analyse the specimens from elderly > 60 years majority of the isolates of Klebsiella
spp E.coli are Multi drug resistant. For bacterial culture in Resistant microorganisms relevant for
community- and hospital-acquired infections include Neisseria meningitides, Salmonella species,
Streptococcus pneumoniae, M. tuberculosis, methicillin-resistant Staphylococcus aureus, Escherichia
coli, and P. falciparum. Peer reviewed data shows higher rates of ciprofloxacin resistance for E. coli,
Proteus mirabilis, and Klebsiella pneumoniae in patient’s ⩾65 years of age, compared with younger

2. patients. Reasons for the increased development of antibiotic resistance in the elderly population of
developing countries are numerous. Clearly, the aging of the population in developing countries will
increase the number of infectious episodes simply because of the increased susceptibility of elderly
individuals to infectious agents. Will these elderly patients with infections also represent a reservoir
that, in turn, leads to increased transmission to the younger population? Targets for such broader
measures include hygiene, water and food sanitation, veterinary surveillance, control of drug sales.
Moreover, aging may be the cause of infection but infection can also be the cause of aging.
WHAT MICROBIOLOGY DEPARTMENTS CAN DO
Physicians need confidence that the results provided by the microbiology laboratory are accurate,
significant, and clinically relevant. Anything less is below the community standard of care. In order to
provide that level of quality, however, the laboratory requires that all microbiology specimens be
properly selected, collected, and transported to optimize analysis and interpretation. Because result
interpretation in microbiology depends entirely on the quality of the specimen submitted for
analysis, specimen management cannot be left to chance, and those that collect specimens for micro
biologic analysis must be aware of what the physician needs as well as what the laboratory needs,
including ensuring that specimens arrive at the laboratory for analysis as quickly as possible after
collection
I wish all the younger generation of Microbiologists should realise in future we get majority of
specimens in Microbiology from elderly population which I am observing in the present Institute
where I am working it is going to be a great challenges to Diagnostic Microbiology I wish we should
improve the quality of life increasing the quality of services in Diagnostic Microbiology along with
Automation and Senior consultant taking interest on matters related to infection and educating the
science of drug resistant strains in ICU and critical care where the aged population are place than the
younger patients,
IN SPITE OF MANY ADVANCES HAND WASHING STILL CONTINUES TO BE BEST BOON IN ELDERLY
PATIENTS AND MEDICAL AND HEALTH CARE WORKER HOW MUCH WE MAKES DIFFERENCE IN
REDUCTION OF INFECTIONS DEFINITELY MAKES THE DIFFERENCE TO PROGRESS OF THE INSTITUTE
WE WORK
Ref Lancet Infect Dis. 2002 Nov; 2(11):659-66. Ageing and infection. Gavazzi G1, Krause KH.
2 A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2013
Recommendations by the Infectious Diseases Society of America (IDSA) and the American Society for
Microbiology (ASM)a Ellen Jo Baron1,2, J et al
Dr.T.V.Rao MD professor of Microbiology Freelance writer