Community-acquired anaerobic bacteremia in adults: one-year experience in a medical center.
A prospective observational study was conducted to evaluate the clinical characteristics and outcome of community-acquired anaerobic bacteremia. From June 1 2001 through May 31 2002, 52 patients with community-acquired anaerobic bacteremia were enrolled at the emergency department in a teaching hospital. There were 19 patients (34%) with polymicrobial bacteremia and Escherichia coli was the most common copathogen (n = 6). Of 62 anaerobic isolates, species of the Bacteroides fragilis group were the most common isolates (n = 28, 45%), followed by Clostridium spp. (n = 11, 18%). Among the 52 patients enrolled, up to 27% had underlying malignancy and the gastrointestinal tract accounted for 48% of the sources of infection. Clinical manifestations suggesting anaerobic infections were common and three-quarters (n = 39) of 52 patients received adequate empirical antimicrobial treatment. Documentation of anaerobic bacteremia seldom influenced antimicrobial treatment. The 30-day mortality was 25%. Although univariate analysis revealed that underlying malignancy (p=0.003), leukopenia (p=0.044) and absence of fever (p=0.047) were associated with mortality, only malignancy (p=0.007) was an independent risk factor in the multivariate analysis.
Hung
Min-Nan
MN
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Chen
Shey-Ying
SY
Wang
Jiun-Ling
JL
Chang
Shan-Chwen
SC
Hsueh
Po-Ren
PR
Liao
Chun-Hsing
CH
Chen
Yee-Chun
YC
D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology / Q000401:mortality; D001421:Bacteria, Anaerobic / Q000187:drug effects / Q000302:isolation & purification; D001441:Bacteroides fragilis / Q000302:isolation & purification; D003013:Clostridium / Q000302:isolation & purification; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011446:Prospective Studies; D013624:Taiwan / Q000453:epidemiology