Enterobacter bacteremia in the community hospital. 1991

R I Haddy, and M L Cecil, and L L Norris, and R J Markert
Department of Family Practice, Wright State University School of Medicine, Dayton, OH.

BACKGROUND The purpose of this study was to examine the epidemiological and clinical characteristics of Enterobacter bacteremia in the community hospital, where nosocomial infections are not commonly studied. METHODS The blood culture records of five community hospitals in the Dayton, Ohio, area were reviewed to find cases of Enterobacter bacteremia. The respective hospital charts were then reviewed. RESULTS Seventy-five episodes of Enterobacter bacteremia were reviewed. Eighty percent (60) of the organisms were nosocomially acquired, and 20% (15) were community acquired. The median age of the patients was 64 years. In 39% (29) of the episodes, fever was not the primary manifestation. The mortality rate was 29% (22). In 30% of the cases, the portal of entry for the bacteremia was unknown. The most common known portals of entry were genitourinary, gastrointestinal or biliary, and peritoneal. The most common underlying disorders were malignancy, postoperative states, and diabetes mellitus. In 9% of the cases, no underlying disorder was detected. The organisms showed high sensitivity to chloramphenicol, aminoglycosides, piperacillin sodium, and cefotaxime sodium. High degrees of resistance were shown to ampicillin, first-generation cephalosporins, and cefoxitin. Eighty-four percent (46) of the patients treated appropriately survived, and 55% (11) of the patients treated inappropriately died. CONCLUSIONS Enterobacter bacteremia is most commonly nosocomially acquired and appears to be a problem in the community hospital. Appropriate therapy improves rates of patient survival.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009820 Ohio State bounded on the north by Michigan and Lake Erie, on the east by Ohio River and Pennsylvania, on the south by Ohio River, and on the west by Indiana.
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D003428 Cross Infection Any infection which a patient contracts in a health-care institution. Hospital Infections,Nosocomial Infections,Health Care Associated Infection,Health Care Associated Infections,Healthcare Associated Infections,Infection, Cross,Infections, Hospital,Infections, Nosocomial,Cross Infections,Healthcare Associated Infection,Hospital Infection,Infection, Healthcare Associated,Infection, Hospital,Infection, Nosocomial,Infections, Cross,Infections, Healthcare Associated,Nosocomial Infection
D003625 Data Collection Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. Data Collection Methods,Dual Data Collection,Collection Method, Data,Collection Methods, Data,Collection, Data,Collection, Dual Data,Data Collection Method,Method, Data Collection,Methods, Data Collection
D004352 Drug Resistance, Microbial The ability of microorganisms, especially bacteria, to resist or to become tolerant to chemotherapeutic agents, antimicrobial agents, or antibiotics. This resistance may be acquired through gene mutation or foreign DNA in transmissible plasmids (R FACTORS). Antibiotic Resistance,Antibiotic Resistance, Microbial,Antimicrobial Resistance, Drug,Antimicrobial Drug Resistance,Antimicrobial Drug Resistances,Antimicrobial Resistances, Drug,Drug Antimicrobial Resistance,Drug Antimicrobial Resistances,Drug Resistances, Microbial,Resistance, Antibiotic,Resistance, Drug Antimicrobial,Resistances, Drug Antimicrobial

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