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[Clinical studies on septicemia and infective endocarditis encountered between 1985-1986]
Abstract:
Septicemia encountered at Kawasaki Municipal Hospital between 1985 and 1986 were studied clinically. Forty six patients had monomicrobial and 5 has polymicrobial infections, respectively. Out of these 46 patients with septicemia, 17 were due to Escherichia coli, 7 were due to Klebsiella pneumoniae and 4 were due to Staphylococcus aureus. Ten patients had hepatobiliary, 7 had hematological, 7 had malignant diseases as underlying diseases, respectively. Out of 10 patients complicated with septic shock, 7 died. Twenty three patients were community acquired infections. The age of most of the patients were over 50. The mortality rate of more than 65-year-old patients were higher than that of other patients. Our of 5 patients with septicemia due to polymicrobial infection, only 1 patient with erythroleukemia died. Fifty patients were treated mainly with beta-lactam antibiotics such as piperacillin or cefmetazole alone or in combination with aminoglycosides and so on. Three patients with infective endocarditis were encountered during this period. Two were due to alpha-streptococcus and 1 was due to Enterococcus. A 41-year-old patient with mitral valve insufficiency and metastatic gastric carcinoma to the bone marrow were complicated with disseminated intravascular coagulation. This patient, however, was successfully treated with a daily dose of 24 mega units of benzylpenicillin, and was given gabexate mesilate, concomitantly.
Insights
This study analyzed 51 septicemia cases from 1985-1986, finding higher mortality in older patients and those with septic shock. Treatment primarily involved beta-lactam antibiotics.
Area of Science:
- Clinical Medicine
- Infectious Diseases
- Bacteriology
Context:
- This retrospective study examines septicemia cases treated at Kawasaki Municipal Hospital between 1985 and 1986.
- The analysis includes patient demographics, causative pathogens, underlying conditions, and treatment outcomes.
Purpose:
- To clinically analyze septicemia cases encountered during the study period.
- To identify risk factors for mortality, including age and underlying diseases.
- To evaluate treatment strategies and their effectiveness.
Summary:
- Fifty-one patients were studied, with 46 having monomicrobial and 5 polymicrobial infections.
- Common pathogens included Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus.
- Hepatobiliary, hematological, and malignant diseases were frequent underlying conditions.
- Septic shock occurred in 10 patients, resulting in 7 deaths.
- Community-acquired infections accounted for 23 cases, with most patients over 50.
- Mortality was higher in patients over 65.
- Three cases of infective endocarditis were reported.
- Treatment predominantly involved beta-lactam antibiotics, often combined with aminoglycosides.
Impact:
- Highlights the significant mortality associated with septicemia, particularly in elderly patients and those with septic shock.
- Provides insights into the common pathogens and underlying conditions contributing to septicemia in this population.
- Informs clinical practice regarding antibiotic selection and management strategies for septicemia.