Clinical and microbiological features of Providencia bacteremia: experience at a tertiary care hospital
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Background/Aims: Providencia species frequently colonize urinary catheters andcause urinary tract infections (UTIs); however, bacteremia is uncommon and notwell understood. We investigated the clinical features of Providencia bacteremiaand the antibiotic susceptibility of Providencia species. Methods: We identified cases of Providencia bacteremia from May 2001 to April2013 at a tertiary care hospital. The medical records of pertinent patients were reviewed. Results: Fourteen cases of Providencia bacteremia occurred; the incidence rate was0.41 per 10,000 admissions. The median age of the patients was 64.5 years. Elevencases (78.6%) were nosocomial infections and nine cases (64.3%) were polymicrobialbacteremia. The most common underlying conditions were cerebrovascular/neurologic disease (n = 10) and an indwelling urinary catheter (n = 10, 71.4%). AUTI was the most common source of bacteremia (n = 5, 35.7%). The overall mortalityrate was 29% (n = 4); in each case, death occurred within 4 days of the onsetof 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 bacteremiascores were significantly higher in nonsurvivors ( p = 0.016, p =0.004, and p = 0.002,respectively). Susceptibility to cefepime, imipenem, and piperacillin/tazobactamwas noted in 100%, 86%, and 86% of the isolates, respectively. Conclusions: Providencia bacteremia occurred frequently in elderly patients withcerebrovascular or neurologic disease. Although Providencia bacteremia is uncommon,it can be rapidly fatal and polymicrobial. These characteristics suggest thatthe selection of appropriate antibiotic therapy could be complicated in Providenciabacteremia.
Abstract
Background/Aims: Providencia species frequently colonize urinary catheters andcause urinary tract infections (UTIs); however, bacteremia is uncommon and notwell understood. We investigated the clinical features of Providencia bacteremiaand the antibiotic susceptibility of Providencia species. Methods: We identified cases of Providencia bacteremia from May 2001 to April2013 at a tertiary care hospital. The medical records of pertinent patients were reviewed. Results: Fourteen cases of Providencia bacteremia occurred; the incidence rate was0.41 per 10,000 admissions. The median age of the patients was 64.5 years. Elevencases (78.6%) were nosocomial infections and nine cases (64.3%) were polymicrobialbacteremia. The most common underlying conditions were cerebrovascular/neurologic disease (n = 10) and an indwelling urinary catheter (n = 10, 71.4%). AUTI was the most common source of bacteremia (n = 5, 35.7%). The overall mortalityrate was 29% (n = 4); in each case, death occurred within 4 days of the onsetof 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 bacteremiascores were significantly higher in nonsurvivors ( p = 0.016, p =0.004, and p = 0.002,respectively). Susceptibility to cefepime, imipenem, and piperacillin/tazobactamwas noted in 100%, 86%, and 86% of the isolates, respectively. Conclusions: Providencia bacteremia occurred frequently in elderly patients withcerebrovascular or neurologic disease. Although Providencia bacteremia is uncommon,it can be rapidly fatal and polymicrobial. These characteristics suggest thatthe selection of appropriate antibiotic therapy could be complicated in Providenciabacteremia.
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