Bacteroides bacteremia.Experience in a hospital for neoplastic diseases

Abstract

The case records of 55 patients with positive blood cultures for Bacteroides species, between the years 1965 and 1970, at Memorial Hospital for Cancer and Allied Diseases were reviewed. Ninety-one per cent of patients had a neoplasm most frequently primary in the large bowel, bladder, gynecologic tract, or metastatic from breast. Less often, acute leukemia or lymphoma was present. The bowel was the most common clinical source of bacteroides, but the female pelvis, postoperative incisions, and decubitus ulcers also served as sites of origin for bacteremia. Abdominal or pelvic surgery often closely preceded the onset of bacteremia. Although 25/55 patients died during the 2-week period following bacteremia, only 17/55 patients died of actual sepsis. The clinical outcome was influenced by the use of antibiotic and drainage therapy. The frequent prolonged incubation period in culture delays the initiation of therapy. Therefore, a high index of suspicion of bacteroides bacteremia should be maintained in the appropriate clinical setting. Tetracycline seemed the best antibiotic with which to initiate treatment pending in vitro sensitivities on the isolate. Bacteroides sp. bacteremia was a relatively frequent cause of sepsis in patients with neoplasms and carried a high mortality rate if not appropriately treated.