INFLAMMATORY MARKERS OF LOWER RESPIRATORY-TRACT INFECTION IN ELDERLY PEOPLE

Bacterial infections of the respiratory tract are a major cause of mor bidity and mortality in elderly people. The inflammatory response to s uch infection is an important protective process and has been suggeste d to be less effective in elderly patients. To investigate the inflamm atory response in respiratory infections acquired in the community by elderly people we studied 52 consecutive patients who met the criteria for either a non-pneumonic chest infection or pneumonia. After exclus ion, 41 patients were available for evaluation, with 25 fulfilling the criteria of pneumonia and 16 the criteria of chest infection. Pyrexia was a feature of the patients with pneumonia. Circulating levels of n eutrophil elastase-alpha-1-antitrypsin complex and C-reactive protein were greater in the patients with pneumonia than in those with a chest infection and were reduced following antibiotic treatment. No changes occurred in the chest infection group for these markers of inflammati on. In both groups, a further neutrophil granule protein, lactoferrin, was unaffected by antibiotic treatment. This study indicates that eld erly patients with pneumonia can initiate an appropriate inflammatory response as demonstrated by clinical indicators and circulating mediat ors of the inflammatory response.