Clinical and microbiological features of Providencia bacteremia: experience at a tertiary care hospital.
OBJECTIVE
Providencia species frequently colonize urinary catheters and cause urinary tract infections (UTIs); however, bacteremia is uncommon and not well understood. We investigated the clinical features of Providencia bacteremia and the antibiotic susceptibility of Providencia species.


METHODS
We identified cases of Providencia bacteremia from May 2001 to April 2013 at a tertiary care hospital. The medical records of pertinent patients were reviewed.


RESULTS
Fourteen cases of Providencia bacteremia occurred; the incidence rate was 0.41 per 10,000 admissions. The median age of the patients was 64.5 years. Eleven cases (78.6%) were nosocomial infections and nine cases (64.3%) were polymicrobial bacteremia. The most common underlying conditions were cerebrovascular/neurologic disease (n = 10) and an indwelling urinary catheter (n = 10, 71.4%). A UTI was the most common source of bacteremia (n = 5, 35.7%). The overall mortality rate was 29% (n = 4); in each case, death occurred within 4 days of the onset of bacteremia. Primary bacteremia was more fatal than other types of bacteremia (mortality rate, 75% [3/4] vs. 10% [1/10], p = 0.041). The underlying disease severity, Acute Physiologic and Chronic Health Evaluation II scores, and Pitt bacteremia scores were significantly higher in nonsurvivors (p = 0.016, p =0.004, and p = 0.002, respectively). Susceptibility to cefepime, imipenem, and piperacillin/tazobactam was noted in 100%, 86%, and 86% of the isolates, respectively.


CONCLUSIONS
Providencia bacteremia occurred frequently in elderly patients with cerebrovascular or neurologic disease. Although Providencia bacteremia is uncommon, it can be rapidly fatal and polymicrobial. These characteristics suggest that the selection of appropriate antibiotic therapy could be complicated in Providencia bacteremia.
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Hee Kyoung
HK
Choi
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Young Keun
YK
Kim
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Hyo Youl
HY
Kim
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Jeong Eun
JE
Park
Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Young
Y
Uh
D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality; D002648:Child; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality; D003430:Cross-Sectional Studies; D024881:Drug Resistance, Bacterial; D004756:Enterobacteriaceae Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011237:Predictive Value of Tests; D011532:Providencia / Q000187:drug effects / Q000302:isolation & purification*; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D055815:Young Adult
D000900:Anti-Bacterial Agents
Bacteremia; Drug resistance, bacterial; Mortality; Providencia