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Related Experiment Videos

Clostridial bacteremia: implications for the surgeon.

C de Virgilio1, S Klein, L Chang

  • 1Department of Surgery, Harbor-UCLA Medical Center, Torrance 90509.

The American Surgeon
|June 1, 1991
PubMed
Summary

Clostridial bacteremia is a rare but highly lethal infection. Key risk factors include decreased tissue oxidation-reduction potential, immunosuppression, and epithelial barrier disruption, leading to high mortality rates.

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Area of Science:

  • Infectious Diseases
  • Microbiology
  • Critical Care Medicine

Background:

  • Clostridial bacteremia is an uncommon infection with a wide spectrum of clinical presentations, ranging from asymptomatic cases to severe septic shock.
  • It is associated with significant morbidity and mortality, often presenting with disseminated intravascular coagulation (DIC), hemolysis, and rapid deterioration.

Purpose of the Study:

  • To identify predisposing factors and prognostic indicators in patients with clostridial bacteremia.
  • To analyze the clinical characteristics and outcomes of clostridial bacteremia in a large patient cohort.

Main Methods:

  • A retrospective review of 47 cases of clostridial bacteremia over a seven-year period at a major metropolitan teaching hospital.
  • Analysis of predisposing factors such as decreased tissue oxidation-reduction potential (Eh), systemic immunosuppression, and epithelial barrier disruption.

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  • Identification of clostridial species, common sites of invasion, and patient outcomes.

    • Main Results:

    • Predisposing factors included decreased Eh (43%), systemic immunosuppression (53%), and epithelial barrier disruption.
    • Common sites of invasion were the gastrointestinal tract (22 cases), pulmonary (7), and cutaneous (7).
    • Histotoxic species (Clostridia perfringens and C. septicum) accounted for 79% of isolates. Overall mortality was 47%, with DIC, renal failure, atherosclerosis, and age being significant prognostic factors.

    Conclusions:

    • Clostridial bacteremia is a rare but highly lethal condition.
    • The presence of decreased tissue Eh, systemic immunosuppression, and epithelial barrier disruption are critical predisposing factors.
    • Advanced age, underlying comorbidities, and infection with histotoxic clostridial species are associated with poor outcomes.