The clinical and bacteriological features of 16 patients with septicemia due to Serratia marcescens are described. Seven patients survived the septicemia, nine did not. All survivors had organisms sensitive to at least one antibiotic and had been treated with the appropriate antibiotic. Both patients who had strains of Serratia resistant to all antibiotics died. Factors that appear to predispose to Serratia infection included prior corticosteroid therapy, the postoperative status, mechanical respiratory manipulation, instrumentation of the genitourinary tract, multiple and "broad-spectrum" antibiotic therapy, and chronic, debilitating disease. More isolates of Serratia were sensitive to kanamycin sulfate than any other antibiotic tested. It is recommended that until specific antibiotic sensitivities can be obtained, patients with Serratia septicemia should be treated with kanamycin in combination with chloramphenicol or ampicillin. Whereas the pathogenicity of S marcescens has been doubted in the past, these data confirm that in certain clinical situations the organism can become
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