Recent Experience with Bacillemia Due to Gram-Negative Organisms

Abstract

During the 19 months ending June, 1969, 136 patients at the Peter Bent Brigham Hospital had 149 episodes of bacillemia due to gram-negative organisms. The incidence of bacillemia (10.7 episodes per 1,000 admissions to the hospital) and the prevalence of infections with Pseudomonas, Serratia, and Klebsiella (46%) were high. Seventy-one percent of the cases of bacillemia were associated with the hospitalization of the patients, and the risk of infection increased with prolonged hospitalization. The rising incidence of bacillemia due to gram-negative organisms appeared to be due largely to an increasing number of hospital-associated cases, which had a higher rate of mortality and were infected with bacilli resistant to more antibiotics. Isolates from blood cultures of 15 patients had transferable R factors. Appropriate antibiotic therapy was associated with decreased mortality. Bacillemia commonly arose from skin infections and clinically inapparent infections in patients with leukemia or lymphoma, from the urinary tract in recipients of renal transplants, and from perforation and obstruction by the tumor mass in patients with carcinoma.