Community-acquired bacteremic urinary tract infection: epidemiology and outcome.

We studied 313 episodes of community-acquired bacteremic urinary tract infection in 4 hospitals of 1 metropolitan area from 1977 to 1981. Although over-all mortality rate for these patients was 13.7 percent, only 15 deaths were attributed directly to bacteremic urinary tract infection according to the criteria used in this study. Of these 15 deaths 13 occurred among patients on medical services, all but 1 of whom had alcoholic liver disease, malignancy and/or chronic neurologic disease. The other patient had brittle diabetes mellitus with renal papillary necrosis and chronic renal failure. In this population 10.4 episodes of community-acquired bacteremic urinary tract infection occurred per 10,000 patients. However, these infections appeared to explain the deaths only of patients with severe underlying diseases.