Ann Clin Microbiol.  2015 Dec;18(4):126-132. 10.5145/ACM.2015.18.4.126.

Eleven-Year Experience of Clostridial Bacteremia at a Tertiary Care Hospital in South Korea

• Kim Y
• Yun JW
• Chun S
• Huh HJ
• Lee NY

• KMID: 2133609
• DOI: http://doi.org/10.5145/ACM.2015.18.4.126

Abstract

BACKGROUND
Clostridial bacteremia (CB) is the second most frequent anaerobic bacteremia, and CB patients show high mortality without prompt antimicrobial therapy. We retrospectively reviewed 11 years of CB cases in a tertiary care hospital to describe the clinical and microbiological characteristics of CB and to define the risk factors of fatal CB.
METHODS
All patients with CB from January 2002 to December 2012 were included in the study. Age, sex, underlying diseases, antibiotic use, and clinical outcome were reviewed. Antibiotic therapy was classified as either 'appropriate' or 'inappropriate' based on the activity against Clostridium species.
RESULTS
A total of 118 Clostridium isolates (0.79% of all blood culture isolates) were recovered from the blood cultures of 114 patients. The underlying conditions of patients with CB were neoplasm in 87 cases (76.3%), gastrointestinal symptoms in 84 cases (73.7%), diabetes in 17 cases (14.9%), and hemodialysis in six cases (5.3%). Of the 118 Clostridium isolates, C. perfringens was the most frequent species (42 isolates, 35.6%). Thirty-two patients (28.1%) showed polymicrobial bacteremia, which was most commonly combined with Escherichia coli. Two patients harbored more than two Clostridium species. 'Appropriate' antibiotics were given to 97 (85.1%) patients. The mortality rate of CB at days 2, 8, and 30 was 7.9% (9/114), 14.0% (16/114), and 26.3% (30/114), respectively.
CONCLUSION
Neoplasm, especially in the gastrointestinal tract or of hematologic origin, and hemodialysis were considered to be risk factors of blood stream clostridial infection. Early appropriate antibiotic coverage of CB was not definitely associated with lower mortality in our study.

Keyword

Anaerobic bacteria; Bacteremia; Clostridium; Sepsis

MeSH Terms

Anti-Bacterial Agents
Bacteremia*
Bacteria, Anaerobic
Clostridium
Escherichia coli
Gastrointestinal Tract
Humans
Korea*
Mortality
Renal Dialysis
Retrospective Studies
Risk Factors
Rivers
Sepsis
Tertiary Healthcare*
Anti-Bacterial Agents

Figure

• 

  Fig. 1. The frequency of each Clostridium species in 118 clostridial isolates.

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