Blood samples, which were obtained from patients who lived in a rural area
with similar to 500 acute-care hospital beds, were cultured from 1990 throu
gh 1997. We retrospectively reviewed the blood cultures that yielded Clostr
idium species (74 [0.12%] of 63,296 cultures). These were obtained from 46
different hospitalized patients (incidents per hospital, 0.03%). The source
of the Clostridium species was a gastrointestinal site in 24 patients (52.
2%). The most frequently identified Clostridium species was Clostridium per
fringens (in 10 [21.7%] of patients), followed by Clostridium septicum (in
9 [19.6%]). Thirty-one patients (67.4%) were aged greater than or equal to
65 years, 13 patients (28.3%) had diabetes mellitus, and underlying maligna
ncy was present in 22 patients (47.8%). The mortality rate of patients whos
e condition had been managed surgically was 33%; for those patients whose c
onditions required medical management, the mortality rate was 58%. Clostrid
ium bacteremia in these patients usually had a gastrointestinal source, it
often occurred in patients with serious underlying medical conditions, and
it rarely was the result of traumatic farm accidents.