Bacteremia in adult men.

A prospective study was done to characterize positive blood cultures in adult male veterans. The research included 277 patients over a 15-month period. There were 348 organisms isolated, of which 65 percent were pathogens, 6 percent probable pathogens, 4 percent probable contaminants, and 25 percent contaminants. The most common isolates were coagulase-negative staphylococci (23 percent), Escherichia coli (12 percent), Klebsiella pneumoniae (10 percent), Staphylococcus aureus (9 percent), Streptococcus pneumoniae (6 percent), and Pseudomonas aeruginosa (5 percent). The number of positive blood cultures was significantly greater for pathogens (mean 1.8 bottles) than contaminants (mean 1.2). Patients with pathogens were more likely to have hypotension than those with contaminants. At least 40 percent of all patients with a positive blood culture died within 14 days after their first positive culture. The vast majority of bacteremias were community acquired. As lungs and wounds comprised about one half of the sites of entry for the bacteremias, it appears that more emphasis should be placed on early diagnosis and efficient treatment of infections from these sites to reduce subsequent mortality.