Pseudomonas aeruginosa bacteremia: relationship of bacterial enzyme production and pyocine types with clinical prognosis in 100 patients.

Strains of Pseudomonas aeruginosa were studied from 100 patients with bacteremia. In vitro quantitation of extracellular enzymes (lecithinase, protease, and elastase) and pyocine typing of these isolates were performed. No significant difference was found in the quantity of the enzymes produced or in the pyocine types by isolates obtained from patients dying from bacteremia or surviving this serious infection. Quantitation of the extracellular enzymes and pyocine types of blood isolates were contrasted with similar data obtained from sputum, urine, and skin isolates. One third of all strains produced minimal or no extracellular enzymes regardless of their source. However, the highest enzyme-producing strains were observed in the blood isolates. Although a greater variability of pyocine types was found in blood culture isolates, there was no significant difference between the pyocine types found in blood, urine, sputum, or skin isolates. The lack of correlation between the in vitro quantity of lecithinase, protease, and elastase produced by P. aeruginosa strains isolated from bacteremic patients and the prognosis of these patients supports the possible local rather than systemic significance of these extracellular enzymes in the pathogenesis of P. aeruginosa bacteremia.