Septicaemia in a general hospital

Over a three-year period, 6102 blood cultures were performed in a large general hospital. Each year, septicaemia was diagnosed in about 0.5% of patients. Detailed examination of one-year records showed that the largest proportion was from the surgical wards, followed by the emergency admitting ward, with smaller numbers from the adult medical, renal and paediatric areas. The organism most frequently responsible was Staphylococcus aureus followed by Escherichia coli. The mortality rate rose from 16% in those treated with one antibiotic, to 58% in those given three or more. Nosocomial infections accounted for 39% of all episodes, with a mortality rate of 29%. At least five cases of these, with two deaths, were attributable to intravenous cannulae. Neutropenia and concurrent immunosuppressive drug therapy were associated with a worse prognosis, but the body temperature and leucocyte count had no prognostic significance.