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Polymicrobial bacteremia.

Y Siegman-Igra1, D Schwartz, N Konforti

  • 1Infectious Disease Unit, Rokach Hospital, Tel-Aviv Medical Center, Israel.

Medical Microbiology and Immunology
|January 1, 1988
PubMed
Summary

Polymicrobial bacteremia, involving multiple microbial species, is common, particularly in older patients. The urinary tract is a frequent source of these serious bloodstream infections.

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Area of Science:

  • Infectious Diseases
  • Microbiology
  • Clinical Medicine

Background:

  • Bacteremia, a bloodstream infection, can be caused by single or multiple microorganisms.
  • Understanding the epidemiology and sources of polymicrobial bacteremia is crucial for effective treatment and patient outcomes.

Purpose of the Study:

  • To prospectively investigate the incidence, sources, microbial characteristics, and outcomes of polymicrobial bacteremia.
  • To identify risk factors and common portals of entry for bloodstream infections involving multiple species.

Main Methods:

  • Prospective study of 585 bacteremic episodes over a 4-year period (1980-1983).
  • Identification and characterization of all microbial strains isolated from blood cultures.
  • Analysis of patient demographics, underlying conditions, infection sources, and mortality rates.

Main Results:

  • 12% of bacteremic episodes (70/585) were polymicrobial, involving 170 strains from 67 patients.
  • Aerobic Gram-negative bacilli were the most common (76%), followed by Gram-positive cocci (21%) and Candida (2%).
  • Urinary tract (31 episodes) and intra-abdominal foci (22 episodes) were the most frequent sources; 56% were hospital-acquired.
  • Mortality was high, with 42% of patients dying as a result of bacteremia.

Conclusions:

  • Polymicrobial bacteremia is a significant clinical problem, often associated with severe underlying diseases and high mortality.
  • The urinary tract represents the most common portal of entry, especially in elderly patients.
  • Hospital-acquired infections, particularly those associated with indwelling devices, contribute substantially to polymicrobial bacteremia.

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