Enterobacter bacteremia in the community hospital.
BACKGROUND
The purpose of this study was to examine the epidemiological and clinical characteristics of Enterobacter bacteremia in the community hospital, where nosocomial infections are not commonly studied.


METHODS
The blood culture records of five community hospitals in the Dayton, Ohio, area were reviewed to find cases of Enterobacter bacteremia. The respective hospital charts were then reviewed.


RESULTS
Seventy-five episodes of Enterobacter bacteremia were reviewed. Eighty percent (60) of the organisms were nosocomially acquired, and 20% (15) were community acquired. The median age of the patients was 64 years. In 39% (29) of the episodes, fever was not the primary manifestation. The mortality rate was 29% (22). In 30% of the cases, the portal of entry for the bacteremia was unknown. The most common known portals of entry were genitourinary, gastrointestinal or biliary, and peritoneal. The most common underlying disorders were malignancy, postoperative states, and diabetes mellitus. In 9% of the cases, no underlying disorder was detected. The organisms showed high sensitivity to chloramphenicol, aminoglycosides, piperacillin sodium, and cefotaxime sodium. High degrees of resistance were shown to ampicillin, first-generation cephalosporins, and cefoxitin. Eighty-four percent (46) of the patients treated appropriately survived, and 55% (11) of the patients treated inappropriately died.


CONCLUSIONS
Enterobacter bacteremia is most commonly nosocomially acquired and appears to be a problem in the community hospital. Appropriate therapy improves rates of patient survival.
Haddy
R I
RI
Department of Family Practice, Wright State University School of Medicine, Dayton, OH.
Cecil
M L
ML
Norris
L L
LL
Markert
R J
RJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D003625:Data Collection; D004352:Drug Resistance, Microbial; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006764:Hospitals, Community / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009820:Ohio / Q000453:epidemiology; D018805:Sepsis / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D015996:Survival Rate
D000900:Anti-Bacterial Agents