Korean J Intern Med.  2015 Mar;30(2):219-225. 10.3904/kjim.2015.30.2.219.

Clinical and microbiological features of Providencia bacteremia: experience at a tertiary care hospital

• Choi HK
• Kim YK
• Kim HY
• Park JE
• Uh Y

• KMID: 2160687
• DOI: http://doi.org/10.3904/kjim.2015.30.2.219

Abstract

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.

Keyword

Providencia; Bacteremia; Drug resistance, bacterial; Mortality

MeSH Terms

APACHE
Adolescent
Adult
Aged
Anti-Bacterial Agents/therapeutic use
Bacteremia/diagnosis/drug therapy/*microbiology/mortality
Child
Cross Infection/diagnosis/drug therapy/*microbiology/mortality
Cross-Sectional Studies
Drug Resistance, Bacterial
Enterobacteriaceae Infections/diagnosis/drug therapy/*microbiology/mortality
Female
Hospital Mortality
Humans
Incidence
Male
Microbial Sensitivity Tests
Middle Aged
Predictive Value of Tests
Providencia/drug effects/*isolation & purification
Republic of Korea
Retrospective Studies
Risk Factors
*Tertiary Care Centers
Treatment Outcome
Young Adult
Anti-Bacterial Agents