Oxidative metabolism has been studied by indirect calorimetry in 27 patients with sepsis and in 7 non-septic patients while they were all receiving total parenteral nutrition. Glucose oxidation was reduced in the septic patients and fat oxidation continued despite the infusion of an excess of glucose. The extent of these changes depended on the severity of the septic state as measured by the scoring system described in the preceding paper. The mechanism of these changes is not known. They were not related to an elevation of the plasma nonesterified fatty acid concentration. Alterations must have occurred in the way fat was taken up and metabolized by the cells. Here insulin resistance and the highly significant positive relationship found between the plasma cortisol concentration and the sepsis score might be important.

organism has now been isolated as a commensal from teeth, For many years Viridans streptococci have been considered nasopharynx, and gastro-intestinal tract (7). as commensal organisms in a wide variety of sites in the However, it is only in recent years that it has been human body and only regarded as significant pathogens in