Aging Begins at 30

Bacteria in the Blood or Septicemia

In a report from Emory University and the Centers for Disease Control in Atlanta by Drs. Martin, Mannino, Eaton and Moss (New England Journal of Medicine for April 17, 2003) septicemia patients seen from 1979 through 2000 in all U.S. nonmilitary hospitals are reviewed. Ten million cases were identified among 750 million hospitalizations over the 22 years. Septicemia occurred in 3% of hospitalizations and 11% of admissions to the ICU. It is probably becoming more common because of more invasive procedures, more immunosuppression, more transplants, more cancer and more chemotherapy than in the past. All these necessary patient manipulations can lead previously localized infections to spread into the blood and around the body. Eventually the total numbers of bacteria in the body destroy the body's energy system and cause death.

Septicemia in this study was more common in men than in women, and in non-white patients than in white patients. It increased by 9% (from 83 to 240 cases per 100,000 population) but fatality rates fell from 28% to 18%. This suggests that both the diagnosis and the treatment have improved. In this 22-year period the availability of infectious disease specialists to give consultations in larger hospitals has increased enormously. Organ failure, especially of the lungs and kidneys, was found in about a third. If there was organ failure in three or more organs, the death rate was 70%, without this problem it was 15%. Therefore prompt diagnosis and early correct treatment is essential. The average age of women patients was 62 and men averaged 57. Over the 22 years the average age in both sexes increased from 57 to 61.

The data in this national study from Atlanta investigators was divided by years into four subsets, and the earliest two quarters showed more gram-negative infections (pink with Dr. Grams stain) like E. coli and salmonella, often from the bowel. In the last two (recent) quarters there were more gram-positive organism septicemias (staining violet with the stain), like staphylococci and streptococci, mainly skin and mouth bacteria. In addition fungi, like candida, in the blood increased throughout the observation period (by 207%). Increasingly patients were discharged to long-term care and rehabilitation reflecting the aging population. The length of hospital stay has shortened. In the past a significant number were in the hospital for 30 days or more and now many stay only seven days or less. This important review shows the progress being made in the treatment of the most severe of our infections.

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See related Patient Topics Bacterial Infections or Infections.

See related Provider Topics Bacterial Infections or Infections.

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