Clinical Features of Clostridial Bacteremia: A Review from a Rural Area

• Published in: Clinical infectious diseases Vol. 33; no. 3; pp. 349 - 353
• Main Authors: Rechner, Paula M., Agger, William A., Mruz, Kathy, Cogbill, Thomas H.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.08.2001; University of Chicago Press
• Subjects: Abscesses; Bacteremia; Bacteremia - diagnosis; Bacteremia - epidemiology; Bacterial diseases; Bacterial sepsis; Biological and medical sciences; Blood; Clostridium; Clostridium - isolation & purification; Clostridium Infections - diagnosis; Clostridium Infections - epidemiology; Clostridium perfringens; Human bacterial diseases; Humans; Infections; Infectious diseases; Medical sciences; Mortality; Review Articles; Risk Factors; Rural areas; Rural Population; Sepsis; Species; Clostridium; Human; Origin; Rural environment; Prognosis; Clostridiales; Bacteremia; Infection; Symptomatology; Microbiological investigation; Etiology; Clostridiaceae; Risk factor; Bacteriosis; Bacteria; Bibliographic review
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/321883

Blood samples, which were obtained from patients who lived in a rural area with ∼500 acute-care hospital beds, were cultured from 1990 through 1997. We retrospectively reviewed the blood cultures that yielded Clostridium species (74 [0.12%] of 63,296 cultures). These were obtained from 46 different hospitalized patients (incidents per hospital, 0.03%). The source of the Clostridium species was a gastrointestinal site in 24 patients (52.2%). The most frequently identified Clostridium species was Clostridium perfringens (in 10 [21.7%] of patients), followed by Clostridium septicum (in 9 [19.6%]). Thirty-one patients (67.4%) were aged ⩾65 years, 13 patients (28.3%) had diabetes mellitus, and underlying malignancy was present in 22 patients (47.8%). The mortality rate of patients whose condition had been managed surgically was 33%; for those patients whose conditions required medical management, the mortality rate was 58%. Clostridium bacteremia in these patients usually had a gastrointestinal source, it often occurred in patients with serious underlying medical conditions, and it rarely was the result of traumatic farm accidents.