Providence bacillus bacteremia and septicopyemia

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      The patient described herein died with bacteremia and septicopyemia caused by Providencia stuartii. The apparent rarity of this occurrence may not be real, since laboratory recourse to the epithet, “paracolon,” probably hides infections actually caused by Providencia species. Assay of virulence by determination of acute median lethal doses (LD50) for mice (intraperitoneal injection), using strains of Providencia species (two from the blood of our patient; six from the urine of other patients), revealed a population of relatively low virulence (LD50 in the range of 104 to 106 bacilli) and high virulence (LD50 in the range of 1 to 50 bacilli). Of the twelve antimicrobial agents tested simultaneously and identically in vitro, kanamycin and gentamicin were the most effective. Carbenicillin and rifamycin-AMP were equally potent and appear to warrant trial in therapy because of lesser liability of toxicity in man.
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