PSEUDOMONAS BACTEREMIA: REVIEW OF NINETY-ONE CASES

Abstract

The records of 88 patients who had 91 bouts of Pseudomonas bacteremia were studied. Eighteen of these occurred in premature infants, 27 among children with serious congenital or acquired diseases, 28 in children and adults with blood dyscrasias, and 18 in adults with a variety of illnesses, frequently following urological instrumentation. The prognosis was poor and only 15 survived. The associated disease state was the most important factor affecting the outcome. The clinical picture was not specific. Fever in infants was unusual and ecthyma gangrenosum which is diagnostic of Pseudomonas septicemia was found in only one patient. Leucopenia was usually associated with leukemia or antedated the infection. Pseudomonas septicemia most often developed as a hospital-acquired infection in patients receiving antibiotics and in 22 instances occurred as a superinfection, frequently after staphylococcal bacteremia. Polymyxin B was the most effective antibiotic but response to treatment was quite variable. Morphological confirmation of the pathogenicity of this organism was obtained in 75% of the 55 autopsied cases.