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Les pneumopathies du sujet âgé: épidémiologie et diagnostic

Pneumonia in the elderly: epidemiology and diagnosis

  • Biologie Médicale et Gériatrie
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Bio tribune magazine

Résumé

Dans le contexte du vieillissement de la population, les pneumopathies infectieuses sont un problème de santé publique parce que leur incidence augmente avec l’âge et parce qu’elles sont responsables d’une proportion plus importante d’hospitalisation et de décès chez les personnes âgées. Dans cette catégorie de la population, la pneumopathie infectieuse est une entité à part, dont les mécanismes physiopathologiques et la prise en charge sont différents de ce qu’on peut observer chez l’adulte jeune. En effet, il faut tenir compte des modifications anatomiques et physiologiques, des modifications de la flore oropharyngée, auxquelles s’ajoutent fréquemment des facteurs de risque et des comorbidités. Le diagnostic est difficile car les symptômes sont souvent atypiques et les examens microbiologiques peu contributifs. Dans ce contexte, le traitement d’une pneumopathie bactérienne supposée repose sur une antibiothérapie probabiliste qui tient compte des spécificités liées à l’âge et de la notion de vie en collectivité.

Abstract

As the population ages, pneumonia has become a main public health problem because of its increasing incidence and its increasing severity with age. Pneumonia in the elderly is a special entity with specific pathogenesis and requires specific management. Ageing is associated with modifications in lung performance, modifications in oropharyngeal flora, and is frequently associated with additional risk factors and comorbidities. The diagnosis of pneumonia in the elderly is a clinical challenge because of a non-typical symptomatology, a poor diagnosis yield of microbiological analysis. In this context, the treatment relies on empirical antibiotic therapy, which takes into account the specificities of older patients.

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Authors and Affiliations

  1. AP-HP, Hôpital Charles-Foix, Equipe Opérationnelle en Hygiène Hospitalière, F-94200, Ivry-sur-Seine, France

    Laurence Drieux

  2. Laboratoire de Bactériologie, UPMC, Université Pierre et Marie Curie-Paris 6, EA 1541, F-75005, Paris, France

    Laurence Drieux

  3. Equipe Opérationnelle en Hygiène Hospitalière, Hôpital Charles Foix, 7, avenue de la République, 94205, Ivry-sur-Seine cedex 5, France

    Laurence Drieux

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Drieux, L. Les pneumopathies du sujet âgé: épidémiologie et diagnostic. Bio trib. mag. 35, 20–25 (2010). https://doi.org/10.1007/s11834-010-0013-9

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