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© 1994 Oxford University Press

research-article

Inflammatory Markers of Lower Respiratory Tract Infection In Elderly People

M. K. ALBAZZAZ, C. PAL, P. BERMAN and D. J. SHALE

Department of Health Care of the Elderly, University of Nottingham City Hospital, Nottinghadm NG5 1PB
University of Wales College of Medicine, Section of Respiratory Medicine Llandough Hospital, Penarth CF6 1XX

Address correspondence to Professor D. J. Shale

Bacterial infections of the respiratory tract are a major cause of morbidity and mortality in elderly people. The inflammatory response to such infection is an important protective process and has been suggested to be less effective in elderly patients. To investigate the inflammatory 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 exclusion, 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 neutrophil elastase-alpha-l-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 inflammation. In both groups, a further neutrophil granule protein, lactoferrin, was unaffected by antibiotic treatment. This study indicates that elderly patients with pneumonia can initiate an appropriate inflammatory response as demonstrated by clinical indicators and circulating mediators of the inflammatory response.

Received December 6, 1993;
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