The Korean journal of internal medicine

  • 제30권2호
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  • Pages.219-225
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  • 2015
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  • 1226-3303(pISSN)
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  • 2005-6648(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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Clinical and microbiological features of Providencia bacteremia: experience at a tertiary care hospital

  • Choi, Hee Kyoung (Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Kim, Young Keun (Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Kim, Hyo Youl (Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Park, Jeong Eun (Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Uh, Young (Department of Laboratory Medicine, Yonsei University Wonju College of Medicine)
  • 투고 : 2014.02.26
  • 심사 : 2014.04.17
  • 발행 : 2015.03.01
⟨ 이전 논문 다음 논문 ⟩

초록

Background/Aims: 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.

키워드

참고문헌

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