Those with a higher death rate included the Hospital of the University of Pennsylvania and Temple University Hospital as well as St. Mary Medical Center in Middletown Township and Crozer-Chester Medical Center in Upland.

Three others - Albert Einstein Medical Center, Bryn Mawr Hospital, and Grand View Hospital - had fewer than expected deaths among infected patients, the Pennsylvania Health Care Cost Containment Council (PHC4) found in its annual hospital performance report.

Experts said the deadly bloodstream infections represented a growing national problem and that local hospitals must do more to prevent them.

The infections killed more than 4,200 patients in Pennsylvania last year, representing a 53 percent rise since 2003, records show.

"There are a growing number of cases across the country, mostly because people are surviving other kind of infections, and they progress and end up in the blood," said Kate Flynn, president of the Health Care Improvement Foundation, a spin-off of the local hospital association.

She said the group identified key areas for improvement and "sepsis is one of those."

Overall, the council examined 31 conditions and treatments, including heart attacks, strokes, prostate surgery, and hysterectomies. An online version of the report due out today at www.phc4.org evaluates an additional 20 areas of care.

The report comes as a political standoff between Gov. Rendell and Senate Republicans threatens to shut down the council.

The agency, recognized nationally for its research, would be closed except for the governor's executive order keeping it open through November.

"Without [legislative] reauthorization of PHC4 . . . in the next few weeks, Pennsylvanians will lose this powerful influence on health care quality and patient safety," said council chairman David R. Kreider in a statement.

He pointed to a recent study in the American Journal of Medical Quality finding that "patients treated at hospitals subjected to intensive public reporting had significantly lower odds of in-hospital mortality."

The hospital report comes a week after the the agency issued its annual study scrutinizing the quality of the region's 22 cardiac programs. The timing was coincidental, said agency spokesman Joe Martin.

Septicemia is a systemic illness in which bacteria and the toxins they produce spread in the blood.

Nearly one in five - 4,281 of the 23,630 patients treated for the infections - died in the state last year, making septicemia the most common killer in the report.

The agency measured how sick patients were, and then set a range of how many should die. Nine hospitals had higher-than-expected death rates, though often just a few deaths put them in the danger zone.

St. Mary had 53 of 172 infected patients die last year. Two fewer deaths would have put the facility into the expected range.

Joseph V. Conroy, St. Mary's chief medical officer, noted that nearly 23 percent of patients arriving with bloodstream infections had "do not resuscitate" orders that led to less aggressive treatment, based on the patient's wishes.

Kathy Scullin, a spokeswoman for Crozer-Chester, said the hospital increased early detection and rapid care of bloodstream infections this spring. "We expect that we will fall within the predicted range by the next reporting period," she said.

At Phoenixville Hospital, another facility cited, chief executive Stephen M. Tullman said the hospital would do a careful evaluation.

"This is the first time" the hospital has had a problem with septicemia, he said.

At Temple and Northeastern Hospitals, an examination found that infections caught in the facilities were a problem and a systemic effort was put in place for the last year. "We have already seen changes in our results," said Temple's chief medical officer, Susan L. Freeman.

At Penn, the problem is identifying incoming patients with the infections sooner, said chief medical officer P.J. Brennan.

"It is really about recognition and other process practices like the timing of antibiotic administration that we are trying to improve on," Brennan said.

Also cited was Fox Chase Cancer Center, where president Michael Seiden said the state's methodology might not properly evaluate cancer patients who are prone to infections.

Chuck Davis, Jennersville Regional Hospital's chief executive officer, said the hospital had few cases, making it hard to evaluate. Cancer Treatment Centers of America could not be reached.

Stuart H. Fine, chief executive of Grand View, which did well, said patients should go beyond one area and evaluate hospitals with other information to get a more complete view.