Interrelations of immunological parameters, nutrition, and healthcare-associated infections: Prospective study in elderly in-patients. Issue 1 (February 2015)

• Record Type: Journal Article
• Authors: Laurent, M.; Bastuji-Garin, S.; Plonquet, A.; Bories, P.N.; Le Thuaut, A.; Audureau, E.; Lang, P.O.; Nakib, S.; Liuu, E.; Canoui-Poitrine, F.; Paillaud, E.
• Is Part Of: Clinical nutrition. Volume 34:Issue 1(2015:Feb.)
• Page Start: 79
• Page End: 85
• Publication Date: 2015-02
• Subjects: Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2014.01.012
• Languages: English
• ISSNs: 0261-5614

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Summary</title> <sec> <title id="sectitle0015">Background & aims</title> <p id="abspara0010">Healthcare-associated infections [HAI] are common in elderly individuals and may be related to both nutritional deficiencies and immunosenescence. Here, we assessed whether overall malnutrition and/or specific nutrient deficiencies were associated with HAI via alterations in immune parameters.</p> </sec> <sec> <title id="sectitle0020">Methods</title> <p id="abspara0015">Prospective observational cohort study in patients aged ≥70 years admitted to the geriatric rehabilitation unit of a teaching hospital in France between July 2006 and November 2008. Clinical and laboratory parameters reflecting nutritional status and immune function were collected at baseline. Flow cytometry was used to assess blood lymphocyte subsets including the naive CD4 T-cell count, naive and memory CD8 T-cell counts, effector CD8 T-cell count, and CD4/CD8 ratio. Patients were monitored for HAI for 3 months or until discharge from the geriatric unit or death.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">Of 252 consecutive in-patients aged ≥70 years [mean age, 85 ± 6.2 years], 181 [72%] met French National Authority for Health criteria for malnutrition and 97 [38%] experienced one or more HAI. Patients who subsequently experienced HAI had significantly lower baseline values for energy intake [odds ratio (OR), 0.76; 95% confidence interval (95%CI), 0.59–0.99], serum albumin [OR, 0.43; 95%CI, 0.32–0.58], serum zinc [OR, 0.77; 95%CI, 0.62–0.97], selenium [OR, 0.76; 95%CI, 0.61–0.95], and vitamin C [OR, 0.71; 95%CI, 0.54–0.93]. Associations linking these five variables to HAI were not significantly changed by adjusting for flow cytometry T-cell subset values.</p> </sec> <sec> <title id="sectitle0030">Conclusion</title> <p id="abspara0025">Our results suggest a direct effect of nutritional parameters on HAI rather than an indirect effect mediated by immune parameters.</p> </sec> </abstract>