During the past 20 years, as the patterns of bacterial infection have gradually changed, new problems have appeared. Of these the resistant staphylococcus and the hospital-acquired infection have recently attracted, perhaps, the greatest attention. In a recent issue of the Archives of Internal Medicine,1 McCabe and Jackson analyze still another facet of increasing importance, the bacteremia caused by gram-negative organisms. In an eight-year survey the authors collected 173 instances wherein blood cultures obtained while the patients were alive were positive for members of the Enterobacteriaceae or Pseudomonadaceae families. No single species was dominant.
The incidence of such bacteremias rose fivefold in the period of observation, fatalities, two-and-one-half-fold. Furthermore, in 72% of all cases the infection apparently was contracted in the hospital. Over-all mortality statistics would be very misleading unless properly analyzed. The authors divide their cases arbitrarily into three broad groups, basing this classification on the severity of the