高齡感染症評估與處置原則

Evaluation and Management of Infection in the Elderly

人口高齡化已經是全球不容忽視的問題，相較於其他慢性內科疾病而言，急性感染症則是造成高齡族群死亡、失能以及入住機構的常見原因。此外，高齡族群的疾病表現較不典型、臨床診斷與評估常見困難，而免疫機能退化、多重共病、用藥、營養不良和既存功能性問題都會影響到產生感染的風險以及治療成功的機會，抗藥性菌株的出現也是常見的情形。如何早期診斷及有效處置成為一個極為重要的課題。針對疫苗可預防性疾病，建議高齡族群都應該接種疫苗以避免可能的健康危害產生。

Aging of a population is an important issue worldwide, and in Taiwan, the proportion of aged people increased to 11.2% of the total population in 2012. Compared with other chronic medical illnesses, acute infection accounts for a majority of the mortality, morbidity, functional impairment, and further institutionalization risks in the elderly. Atypical symptom presentations of acute illness and difficulties in evaluation and diagnosis are common problems experienced in the management of infections. Immunosenescence, multi-morbidities, polypharmacy, malnutrition, and functional impairment further increase the risk of infection and the complexity of management. Moreover, infection by resistant pathogens poses an additional difficulty in treatment. Thus, early detection and effective management help prevent such adverse outcomes in the elderly. For vaccine-preventable diseases, vaccination is strongly recommended.