Antibody response of patients with malignancies to bacteremia with gram-negative bacteria

Antibody response, determined by means of the indirect bacterial hemagglutination tests, was studied in 58 consecutive patients with various malignancies whose blood culture yielded growth of Enterobacteriaceae or Pseudomonas and from whom serum specimens were obtained. Of these patients 59% had a significant antibody response. The invading microorganisms were Escherichia coli in 33 and Klebsiella in 19 subjects, an antibody response being documented with essentially equal frequency (60 and 57% of the subjects, respectively). Two patients had positive blood cultures for both E. coli and Klebsiella, one of whom had a significant response to one isolate only. A specific antibody resonse was documented in 67% of the subjects from whom blood for antibody titration was obtained at least 5 days after the blood culture, but from only 21% of patients whose serum was procured during the first 5 days after the blood culture. Similarly, such an antibody response was identified in 73% of subjects with two consecutive serum specimens, but in only 28% of the patients with a single serum specimen for antibody titration. Documentation of the immune response may be of diagnostic aid in differentiating between infection and contamination even in patients with underlying malignancy and under potentially immunosuppressive therapy.