[247 episodes of sepsis at a medical department of a district hospital].

In a retrospective study some epidemiologic and clinical aspects of 247 sepsis episodes observed during the period 1983-88 in the Medical Department of Locarno District Hospital are analyzed. 61% of the 233 patients were aged over 70 and 48% had one or more underlying diseases predisposing them for infection. The commonest sepsis pathogens were gram-negative bacilli (59% of all isolates), followed by pneumococci (15%) and staphylococci (14%). Over 99% of gram-negative pathogens were sensitive to gentamicin, 92% to ceftriaxone. 78% to amoxycillin clavulanate, 74% to cotrimoxazole and 59% to ampicillin; 19% of staphylococcus strains were methicillin-resistant. The most frequent sites of entry for the pathogens were urinary tract (39% of all episodes), the lower respiratory tract (22%) and the gastrointestinal tract (12%). Infection-related mortality was 9% and total hospital mortality 18%. The least favourable prognostic factors were severity of the underlying disease, initial circulatory shock and pulmonary localization of infection (especially where the causative agents were other than pneumococci).