A cluster of seven cases ofClostridium tertium septicemia in neutropenic patients

Abstract

A cluster of seven febrile and severely neutropenic patients who developedClostridium tertium septicemia during a 13-month period is described. The patients had received third generation cephalosporins for 7 to 13 days (mean 9 days) at the timeClostridium tertium was isolated from blood cultures. Two patients had perirectal and one patient pericaecal cellulitis. The organism was also isolated from bronchial secretions in one patient. No patient had diarrhea. Five of six strains tested were resistant to clindamycin (MIC 2–8 µg/ml), and six of seven strains moderately resistant to penicillin (MIC 1–4 µg/ml). In one patientClostridium tertium grew from blood cultures although metronidazole had been administered for two days. Six patients recovered on antibiotic therapy. In view of the unusual susceptibility pattern ofClostridium tertium, an accurate diagnosis of infection with this organism is important for the choice of an appropriate antimicrobial treatment.