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Multiple Organism Septicemia in Acute Leukemia: Analysis of 54 Episodes

Multiple Organism Septicemia in Acute Leukemia: Analysis of 54 Episodes Abstract ORGANISMS of low pathogenicity often cause serious infections in patients with acute leukemia. Septicemia is a major problem and often proves fatal. Although usually only one organism is recovered from the blood, the isolation of multiple organisms is not infrequent. We have reviewed our experience with 54 episodes of multiple organism septicemia in 52 patients with acute leukemia. Methods Four hundred twenty patients with acute leukemia were admitted to the National Institutes of Health from October 1953 to August 31, 1963. The clinical records and autopsy protocols of these patients were examined. Patients were included in the study if more than one organism was grown from their blood in a single culture or from separate cultures during any two-week period, but not if they contained obvious contaminants such as Staphylococcus albus, diphtheroids, α-hemolytic Streptococcus or group D Streptococcus. Postmortem heart blood cultures were not included unless a morphologically consistent site References 1. Hochstein, H.D.; Kirkham, W.R.; and Young, V.M.: Septicemias With More Than One Organism Recovered, to be published. 2. Freireich, E.J., et al: Function and Fate of Transfused Leukocytes From Donors With Chronic Myelocytic Leukemia in Leukopenic Recipient , Ann NY Acad Sci 113:1081, 1964.Crossref 3. Brill, N.E., and Libman, E.: Pyocyaneous Bacillaemia: Critical Review of Recorded Cases, With Report of Cases Secondary to Staphylococcemia , Amer J Med Sci 118:153, 1899.Crossref 4. Czerny and Moser, cited in Brill, N.E., and Libman, E. 3. 5. Doane, J.C., and Cates, H.B.: Double Bacteremia (Strep viridans and Staph aureus) Diagnosed Before Death , Amer J Med Sci 185:772, 1933.Crossref 6. Vogel, F.: Phlebothrombotic Disease of Rectum Associated With Strep fecalis and Bacillus coli Septicemia , Amer J Gastroent 28:429, 1957. 7. Marquezy, R.A., et al: Septicémie mixte à staphylocoque et a Candida albicans—candidose cerebrale , Arch Franc Pediat 16:1215, 1959. 8. Smith, R.T.: Septicemia and Meningitis in Newborn Infant , J Pediat 47:740, 1955.Crossref 9. McHenry, M.C., et al: Bacteremia in Patients With Neoplastic or Hematologic Disease , Proc Mayo Clin 37:43, 1962. 10. Adams, D.S.: Report of 12 Cases of Septicemia , New Eng J Med 201:884, 1929.Crossref 11. Appelbaum, E., and Leff, W.A.: Occurrence of Superinfections During Antibiotic Therapy , JAMA 138:119, 1948.Crossref 12. Dunham, E.C.: Septicemia in Newborn , Amer J Dis Child 45:229, 1933. 13. Koch, M.L.: Bacteremia Due to Bacterial Species of Genera Aerobacter, Escherichia, Paracolobactrum, Proteus, and Pseudomonas , Antibiot Med 2:113, 1956. 14. Neuhof, H.; Aufses, A.H.; and Heishfield, S.: Pyogenic Sepsis , Surg Gynec Obst 58:886, 1934. 15. Finkelstein, cited in Brill, N. E., and Libman, E.3 16. Kanof, A., and Kramer, B.: Multiple Invasion of Blood Stream , J Lab Clin Med 27:173, 1941. 17. McCabe, W.R., and Jackson, G.G.: Gram-Negative Bacteremia: I. Etiology and Ecology , Arch Intern Med 110:847, 1962.Crossref 18. Scott, W.W.: Blood Stream Infections in Urology , J Urol 21:527, 1929. 19. Warren, M., and Herrick, W.W.: Analysis of 134 Cases of Bacteremia , Amer J Med Sci 151:556, 1916.Crossref 20. Curtin, J.A.; Petersdorf, R.G.; and Bennett, I.L., Jr.: Pseudomonas Bacteremia: Review of 91 Cases , Ann Intern Med 54:1077, 1961.Crossref 21. Libman, E.: On Some Experiences With Blood-Cultures in Study of Bacterial Infections , Bull Hopkins Hos 17:215, 1906. 22. Kotin, P.: Techniques and Interpretation of Routine Blood Cultures: Observations in 5000 Consecutive Patients , JAMA 149:1273, 1952.Crossref 23. Hersh, E.M., et al: Fatal Complications of Acute Leukemia, to be published. 24. Gordano, A.S., and Barnes, A.R.: Studies in Post-Mortem Bacteriology: Value and Importance of Cultures Made Post Mortem , J Lab Clin Med 7:538, 1921-1922. 25. Hunt, H.F., et al: Bacteriologic Study of 567 Post-Mortem Examinations , J Lab Clin Med 14:907, 1929. 26. Kurtin, J.J.: Studies in Autopsy Bacteriology , Amer J Clin Path 30:239, 1958. 27. Silver, R.T., et al: Fever, Infection and Host Resistance in Acute Leukemia , Amer J Med 24:25,1958.Crossref 28. Levin, R.H.; Landy, M.; and Frei, E. III: Effect of 6-Mercaptopurine on Immune Responses in Man , New Eng J Med 271:16, 1964.Crossref 29. Hersh, E.; Carbone, P.P.; and Freireich, E.J.: Inhibition of Primary Immune Response in Man by Antimetabolites, to be published. 30. Robinson, H.J.: Adrenal Steroids and Resistance to Infection , Antibiot Chemother 7:199, 1960. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Multiple Organism Septicemia in Acute Leukemia: Analysis of 54 Episodes

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References (34)

Publisher
American Medical Association
Copyright
Copyright © 1965 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1965.03870020106019
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Abstract

Abstract ORGANISMS of low pathogenicity often cause serious infections in patients with acute leukemia. Septicemia is a major problem and often proves fatal. Although usually only one organism is recovered from the blood, the isolation of multiple organisms is not infrequent. We have reviewed our experience with 54 episodes of multiple organism septicemia in 52 patients with acute leukemia. Methods Four hundred twenty patients with acute leukemia were admitted to the National Institutes of Health from October 1953 to August 31, 1963. The clinical records and autopsy protocols of these patients were examined. Patients were included in the study if more than one organism was grown from their blood in a single culture or from separate cultures during any two-week period, but not if they contained obvious contaminants such as Staphylococcus albus, diphtheroids, α-hemolytic Streptococcus or group D Streptococcus. Postmortem heart blood cultures were not included unless a morphologically consistent site References 1. Hochstein, H.D.; Kirkham, W.R.; and Young, V.M.: Septicemias With More Than One Organism Recovered, to be published. 2. Freireich, E.J., et al: Function and Fate of Transfused Leukocytes From Donors With Chronic Myelocytic Leukemia in Leukopenic Recipient , Ann NY Acad Sci 113:1081, 1964.Crossref 3. Brill, N.E., and Libman, E.: Pyocyaneous Bacillaemia: Critical Review of Recorded Cases, With Report of Cases Secondary to Staphylococcemia , Amer J Med Sci 118:153, 1899.Crossref 4. Czerny and Moser, cited in Brill, N.E., and Libman, E. 3. 5. Doane, J.C., and Cates, H.B.: Double Bacteremia (Strep viridans and Staph aureus) Diagnosed Before Death , Amer J Med Sci 185:772, 1933.Crossref 6. Vogel, F.: Phlebothrombotic Disease of Rectum Associated With Strep fecalis and Bacillus coli Septicemia , Amer J Gastroent 28:429, 1957. 7. Marquezy, R.A., et al: Septicémie mixte à staphylocoque et a Candida albicans—candidose cerebrale , Arch Franc Pediat 16:1215, 1959. 8. Smith, R.T.: Septicemia and Meningitis in Newborn Infant , J Pediat 47:740, 1955.Crossref 9. McHenry, M.C., et al: Bacteremia in Patients With Neoplastic or Hematologic Disease , Proc Mayo Clin 37:43, 1962. 10. Adams, D.S.: Report of 12 Cases of Septicemia , New Eng J Med 201:884, 1929.Crossref 11. Appelbaum, E., and Leff, W.A.: Occurrence of Superinfections During Antibiotic Therapy , JAMA 138:119, 1948.Crossref 12. Dunham, E.C.: Septicemia in Newborn , Amer J Dis Child 45:229, 1933. 13. Koch, M.L.: Bacteremia Due to Bacterial Species of Genera Aerobacter, Escherichia, Paracolobactrum, Proteus, and Pseudomonas , Antibiot Med 2:113, 1956. 14. Neuhof, H.; Aufses, A.H.; and Heishfield, S.: Pyogenic Sepsis , Surg Gynec Obst 58:886, 1934. 15. Finkelstein, cited in Brill, N. E., and Libman, E.3 16. Kanof, A., and Kramer, B.: Multiple Invasion of Blood Stream , J Lab Clin Med 27:173, 1941. 17. McCabe, W.R., and Jackson, G.G.: Gram-Negative Bacteremia: I. Etiology and Ecology , Arch Intern Med 110:847, 1962.Crossref 18. Scott, W.W.: Blood Stream Infections in Urology , J Urol 21:527, 1929. 19. Warren, M., and Herrick, W.W.: Analysis of 134 Cases of Bacteremia , Amer J Med Sci 151:556, 1916.Crossref 20. Curtin, J.A.; Petersdorf, R.G.; and Bennett, I.L., Jr.: Pseudomonas Bacteremia: Review of 91 Cases , Ann Intern Med 54:1077, 1961.Crossref 21. Libman, E.: On Some Experiences With Blood-Cultures in Study of Bacterial Infections , Bull Hopkins Hos 17:215, 1906. 22. Kotin, P.: Techniques and Interpretation of Routine Blood Cultures: Observations in 5000 Consecutive Patients , JAMA 149:1273, 1952.Crossref 23. Hersh, E.M., et al: Fatal Complications of Acute Leukemia, to be published. 24. Gordano, A.S., and Barnes, A.R.: Studies in Post-Mortem Bacteriology: Value and Importance of Cultures Made Post Mortem , J Lab Clin Med 7:538, 1921-1922. 25. Hunt, H.F., et al: Bacteriologic Study of 567 Post-Mortem Examinations , J Lab Clin Med 14:907, 1929. 26. Kurtin, J.J.: Studies in Autopsy Bacteriology , Amer J Clin Path 30:239, 1958. 27. Silver, R.T., et al: Fever, Infection and Host Resistance in Acute Leukemia , Amer J Med 24:25,1958.Crossref 28. Levin, R.H.; Landy, M.; and Frei, E. III: Effect of 6-Mercaptopurine on Immune Responses in Man , New Eng J Med 271:16, 1964.Crossref 29. Hersh, E.; Carbone, P.P.; and Freireich, E.J.: Inhibition of Primary Immune Response in Man by Antimetabolites, to be published. 30. Robinson, H.J.: Adrenal Steroids and Resistance to Infection , Antibiot Chemother 7:199, 1960.

Journal

Archives of Internal Medicine – American Medical Association

Published: Aug 1, 1965

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