Urinary Tract and Genitourinary Suppurative Infections

Anaerobes have been involved in many different types of urinary tract infection (UTI). The types of infections of the urinary tract in which anaerobes have been involved include para- or periurethral cellulitis or abscess, acute and chronic urethritis, cystitis, acute and chronic prostatitis, prostatic and scrotal abscesses, periprostatic phlegmon, ureteritis, periur-eteritis, pyelitis, pyelonephritis, renal abscess, scrotal gangrene, metastatic renal infection pyonephrosis, perinephric...

Microbiology

Infective keratitis can be viral, bacterial, fungal and due to Acanthamoeba. The main viruses are herpes simplex, varicella-zoster, measles, mumps, rubella, adenovirus, coxsackievirus A24, and enterovirus 70. Fungal causes are rare and include Aspergillus, Fusarium solani, and Candida albicans. Bacterial causes include S. pneumoniae, S. aureus, and S. epidermidis. Pseudomonas aeruginosa is common in contact lens wearers H. influenzae and M. catarrhalis cause ulcerative veratitis and enteric...

Acute Otitis Externa Swimmers

External otitis is defined as a varying degree of an inflammation of the auricle, external ear canal, or outer surface of the tympanic membrane (67). The etiology of the inflammation can be an infection, inflammatory dermatoses, trauma, or a combination of these. The clinical infection is divided to be either localized or diffuse, and acute or chronic. Predisposing factors to infection include extraneous trauma, loss of the canal's protective water-repellent coating provided by the cerumen,...

Bacteriology of Nosocomial Sinusitis

Nosocomial sinusitis often develops in patients who require extended periods of intensive care (postoperative patients, burn victims, and patients with severe trauma) involving prolonged endotracheal or nasogastric intubation. P. aeruginosa and other aerobic and facultative gramnegative rods are common in sinusitis of nosocomial origin (especially in patients who have nasal tubes or catheters), the immunocompromised, patients with human immune deficiency viral infection and patients who suffer...

Microbiology of Acute Sinusitis

Viral infection (mostly Rhino, influenza, adeno, and para-influenza viruses) is the most common predisposing factor for URTIs, including sinusitis. Viral infection can also concur with the bacterial infection. The mechanism whereby viruses predispose to sinusitis may involve viral-bacterial synergy, induction of local inflammation that blocks the sinus ostia, increase of bacterial attachment to the epithelial cells, and disruption of the local immune defense. The bacteria recovered from...

Management

Penicillin has been the mainstay for treatment of tonsillar infections because of its effectiveness against GABHS. However, the rate of penicillin failure in eradicating GABHS from infected tonsils has slowly increased over the past 50 years from about 7 to 38 (39,40). As a final resort, many of these patients are referred for tonsillectomy. Penicillin failure in eradicating GABHS tonsillitis has several explanations. These include noncompliance with 10-day course of therapy, carrier state,...

Acute Salpingitis And Pelvic Inflammatory Disease Pathogenesis and Microbiology

PID usually begins with cervical infection that is caused by C. trachomatis, N. gonorrhoeae, or both. Acute salpingitis and PID occur after extension of the infection from the lower parts of the female genital tract to higher structures. Organisms infecting the cervix can spread to involve the uterus and fallopian tubes in two ways by causing a transient endometritis that extends to involve the endosalpinx or by reaching the tubes via lymphatic spread. Acute salpingitis and PID may be...

Role of Beta LactamaseProducing Bacteria

Bacterial resistance to the antibiotics used for the treatment of sinusitis has consistently increased in recent years. Production of the enzyme beta-lactamase is one of the most important mechanisms of penicillin resistance. Several potential aerobic and anaerobic BLPB occur in sinusitis. BLPB have been recovered from over a third of patients with acute and chronic sinusitis (8-11,18). H. influenzae and M. caterrhalis are the predominate BLPB in acute sinusitis (18) and S. aureus, pigmented...

Acute Otitis Media Microbiology

Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are the principal etiologic agents in bacterial AOM accounting for about 80 of the bacterial isolates (2,3). S. pneumoniae has constantly been found more commonly, irrespective of age group, but its predominance has tended to decrease following the introduction of the pneumococcal conjugate vaccine in 2000 (4), where the frequency of isolation of H. influenzae increased. Of special concern is the increased rate of...

Single Agent vs Combined Antimicrobial Therapy

The principles of using antimicrobial coverage effective against both aerobic and anaerobic offenders involved in polymicrobial infections have become the cornerstone of practice 8,9,88 and have been confirmed by numerous studies especially in intra-abdominal infections 89,90 . The success rate in curing mixed infections varies between studies but the difference between various therapeutic regimens was not statistically significant as long as the therapies adequately covered both...

Central Nervous System

Infections of the CNS are very rare and generally manifest as single or multiple encapsulated brain abscesses that appear as ring-enhancing lesions with thick wall that may be irregular or nodular on CT with intravenous contrast material and are indistinguishable from those caused by other organisms 6 . Rarely, solid nodular or mass lesions termed actinomycetomas or actinomycotic granulomas are found. Headache and focal neurological signs are the most common finding. Most actinomycotic...

Animal Bites

Almost any aerobic and anaerobic oral flora isolate is a potential pathogen, and therefore the bacteriology of these bite wounds varies and needs individual study 33-38 . Holst et al. 14 investigated the distribution of 159 P. multocida isolates from bite wounds. P. multocida accounted for 60 of the isolates and was recovered from all cases of bacteremia. Pasteurella septica, accounted for 13 of isolates, was more commonly isolated from cat than from dog bites and caused more central nervous...

Classification And Diagnosis Impetigo

Streptococcal impetigo manifests itself as appearance of small vesicles that rapidly pustulate and rupture. After the purulent discharge dries, a golden-yellow crust forms. The lesions remain superficial and do not ulcerate or infiltrate the dermis. Pain and scarring do not occur. The bullous form of impetigo is due to Staphylococcus aureus phage group II, usually type 71 . The initial vesicles turn into fluid bullae that quickly rupture, leaving a moist red surface, which then generates...

Antimicrobial Therapy of Chronic Sinusitis

Many of the pathogens found in chronically inflamed sinuses are resistant to penicillins through the production of beta-lactamase 8-11 . These include both aerobic S. aureus, H. influenzae, and M. catarrhalis and anaerobic isolates B. fragilis group and over half of the TABLE 6 Empirical Antimicrobial Therapy in Acute Bacterial Sinusitis Amoxicillin Therapy high-dose Mild illness No history of recurrent acute sinusitis During summer months When no recent antimicrobial therapy has been used When...

Mixed Infections Involving Anaerobic BLPB

Anaerobic BLPB can be isolated from a variety of infections in adults and children, sometimes as the only isolates and sometimes mixed with other flora Table 3 . Table 4 summarizes our experience in the recovery of these organisms from skin and soft tissue infections 157-166 , upper respiratory tract 167-179 , lower respiratory tract 180-183 , obstetric and gynecologic 184 , intra-abdominal 184-186 , and miscellaneous infections 187-190 . The rate of isolation of these organisms varies in each...

Bacteriology of Sinusitis of Odontogenic Origin

Odontogenic sinusitis is a well-recognized condition and accounts for approximately 10 to 12 of cases of maxillary sinusitis. Brook 16 studied the microbiology of 20 acutely and 28 chronically infected maxillary sinuses that were associated with odontogenic infection. Polymicrobial infection was very common with 3.4 isolates specimen and 90 of the isolates were anaerobes in both acute and chronic infections. The predominant anaerobic bacteria were AGNB, Peptostreptococcus spp., and...

Microbiology and Pathogenesis

The predominant anaerobes causing meningitis are gram-negative bacilli including Bacteroides fragilis group , Fusobacterium spp. mostly F. necrophorum , and Clostridium spp. mostly Clostridium perfringens 1,2 . Peptostreptococcus spp., VeiUoneUa, Actinomyces, Propionibacterium acnes, and Eubacterium are less commonly isolated. The main predisposing conditions to anaerobic meningitis are ear, nose, and throat infections, gastrointestinal disease, and skull fractures. Less common causes are skull...

Endometritis and Pyometra

Endometritis and pyometra are seen more commonly in older females who suffer from cervical canal obstruction or carcinoma or following delivery. However, they can also be seen occasionally in adolescent females. Endometritis occurs when bacteria invade the uterine cavity, and pyometra develops when pus is collected within the uterus. Regardless of the etiology, anaerobes are predominant in endometritis and pyometra. Hillier et al. 26 obtained endometrial biopsies for histologic and...

Lateral Pharyngeal Space

The lateral pharyngeal space is continuous with the carotid sheath. Involvement of this space may follow pharyngitis, tonsillitis, otitis, parotitis, and odontogenic infections. Anterior compartment involvement is characterized by fever, chills, pain, tremors, and swelling below the angle of the jaw. Posterior compartment infection is characterized by septicemia, often with few local signs. Other complications include edema of the larynx, asphyxiation, internal carotid artery, and erosion...

References

Skin and soft-tissue infections. Lancet 1988 1 8578 164-8. 2. Brook I, Frazier EH. Aerobic and anaerobic bacteriology of wounds and cutaneous abscesses. Arch Surg 1990 125 1445-51. 3. Meislin HW, Lerner SA, Graves MH, et al. Cutaneous abscesses anaerobic and aerobic bacteriology and outpatient management. Ann Intern Med 1977 7 145-9. 4. Rosebury T. Microorganisms Indigenous to Man. New York McGraw-Hill, 1962. 5. Brook I. Presence of beta-lactamase-producing bacteria and...

Pathogenesis

Because the mucous membranes lining the nasal chambers and the sinuses are alike histologically and are continuous with each other through the natural ostium, URTI commonly result in an inflammatory sinusitis. Sinusitis of nondental genesis is considered to be preceded by a viral, mechanical, or allergic stage when the nasal and paranasal mucosa are hyperemic and the permeability of the ostium is decreased. At that stage, the sealed-off sinus that fails to drain freely is prone to secondary...

Etiology

Numerous reports have implied that the fecal microflora may contribute to the pathogenesis of NEC. A broad range of organisms generally found in the distal gastrointestinal tract have been recovered from the peritoneal cavity and blood of infants with NEC. Infectious agents recovered from newborns with endemic NEC are similar to those associated with epidemic NEC. Organisms cultured from the blood usually matched with those found in the stool 1,2,12 . Most reports describe the predominance of...

Dental Caries

The first step in the origination of caries is the formation of a dental plaque 2 . An increase in the amount of plaque is responsible for the ultimate development of gingivitis. A variety of factors interact in the generation of dental plaque and subsequent emergence of caries. These include the presence of a susceptible tooth surface, the proper microflora, and a suitable nutritional substrate for that flora. Several oral acid producing aerobic and anaerobic bacteria, including Streptococcus...

The Newborns Maturity

Preterm babies are also colonized by facultatively anaerobic bacteria from the first days of life, and these remained at high levels resembling the full-term formula-fed babies. However, the intestinal colonization of preterm infants differed from that in full-term, breast-fed infants in the high counts of facultatively anaerobic bacteria and late appearance of bifidobacteria and from both groups of full-term infants in the early stable colonization by Bacteroides spp. 54 . It is postulated...

Carbapenems Imipenem Meropenem and Ertapenem

Imipenem, a thienamycin, is a beta-lactam antibiotic that is effective against a wide variety of aerobic and anaerobic gram-positive and gram-negative organisms including normally multiresistant species such as P. aeruginosa, Serratia spp., Enterobacter spp., Acinetobacter spp., and enterococcus 41,42 . It also possesses excellent activity against beta-lactamase-producing Bacteroides. It has the lowest MIC for B. fragilis group and is also most effective against Entero-bacteriaceae. About 10-25...

Vulvovaginal Pyogenic Infections

Vulvovaginal pyogenic infections include abscesses of Bartholin's and Skene's glands, infected labial inclusion cysts, labial abscesses, furunculosis, and hidradenitis 6 . Most infections are related to both aerobic and anaerobic organisms arising from the normal vaginal and cervical flora. N. gonorrhoeae is responsible for approximately 10 of these infections. The majority of nonvenereal abscesses are caused by anaerobic bacteria. Parker and Jones 18 recovered anaerobes in two-thirds of 75...

Anaerobes as Part of the Human Indigenous Microbial Flora

Images Anaerobic Bacteria

The human mucous and epithelial surfaces are colonized with aerobic and anaerobic microorganisms 1 . These surfaces are the skin, conjunctiva, mouth, nose, throat, lower intestinal tract, vagina, and the urethra. The trachea, bronchi, esophagus, stomach, and upper urinary tract are not normally colonized by indigenous flora. However, a limited number of transient organisms may by present at these locations. Differences in the environment, such as oxygen tension and pH and variations in...

Anaerobic Bacteria

Retrograde Thrombophlebitis

Sinus infection when not treated promptly and properly may spread via anastomosing veins or by direct extension to nearby structures Fig. 5 . Orbital complication was categorized by Chandler et al. 67 into five separate stages according to its severity see chapter 11 . Contiguous spread could reach the orbital area, resulting in periorbital cellulitis, subperiosteal abscess, orbital cellulitis, and abscess. Orbital cellulitis may complicate acute ethmoiditis if a thrombophlebitis of the...

Ascending Cholangitis Following Portoenterostomy

Extrahepatic biliary atresia is an obliterative cholangiopathy that involves all or part of the extrahepatic biliary tree and, in many instances, the intrahepatic bile ducts. In the U.S.A., from 400 to 600 new cases of biliary atresia are encountered annually 46 . The diagnosis is usually suggested by the persistence of jaundice for six weeks or more after birth. Several factors have been considered for the pathogenesis of extrahepatic biliary atresia, including viral infection e.g.,...

Odontogenic Infections

The complexity of the oral and gingival flora has prevented the clear elucidation of specific etiologic agents in most forms of oral and dental infections. In the gingival crevice, there are approximately 1.8 X1011 anaerobes per gram 1 . Because anaerobic bacteria are part of the normal oral flora and outnumber aerobic organisms by a ratio of 1 10 to 1 100 at this site, it is not surprising that they predominant in dental infections. There are at least 350 morphological and biochemically...

Peptostreptococcus Spp In Cervical

Infectious CL can be either acute unilateral or bilateral, and chronic subacute . Because of the high frequency of CL in children, most microbiological studies were done in this age group. The most common causes of bilateral CL in children are viruses. However, the adenitis appears and resolves quickly without treatment. The most common viruses are EB, cytomegalovirus, herpes simplex, adeno virus, enterovirus, roseola, and rubella. Other pathogens include Mycoplasma pneumoniae and...

Adult Intestinal Toxemia Botulism

Adult intestinal toxemia botulism occurs rarely and sporadically, and it results from the absorption of toxin produced in situ by botulinum toxin-producing Clostridia that colonizes the intestine. Generally, patients have an anatomical or functional bowel abnormality or are using antimicrobials, which may select fastidious Clostridium species from the normal bowel flora 30,35,36 . The symptoms may be protracted and relapsed even after treatment with antitoxin because of the ongoing intraluminal...

Microbiology Impetigo

Most cases of impetigo and cellulitis are attributed to S. aureus and GABHS alone or in combination Table 2 19 . A retrospective study investigated both the aerobic and anaerobic Impetigo and cellulitis, diabetic, and chronic skin ulcers Streptococcus group A Staphylococcus aureus Anaerobic oral flora Prevotella, Fusobacterium, and Peptostreptococcus spp. around oral area and head and neck Colonic flora Enterobacteriaceae and anaerobes i.e., Escherichia coli and Bacteroides fragilis group...

Lincomycin and Clindamycin

The in vitro susceptibility of various anaerobic bacteria to lincomycin was initially demonstrated in 1965 56 . Subsequently, the 7-chloro-7-deoxylincomycin analog, clindamycin, was found to be even more active against anaerobes than the parent compound 13 . Lincomycin is highly active against a variety of anaerobic bacteria however, clostridia, B. fragilis, and F. varium are relatively resistant to lincomycin 13 . Clindamycin has a broad range of activity against anaerobic organisms and has...

Elimination Of Gabhs

Antimicrobials that are effective against BLPB as well as GABHS have been shown to be effective in the elimination of GABHS in acute and chronic infections or the eradication of GABHS carrier state. These include lincomycin, clindamycin 54-69 , penicillin plus rifampin, and the combination of amoxicillin and clavulanic acid 65 Table 3 . Other drugs that may also be effective are the combination of metronidazole and a macrolide. Clindamycin was also found to be superior to penicillin in...

Clindamycin Resistance

Clindamycin has been used for the treatment of anaerobic infection since the 1960s. Resistance to clindamycin among anaerobes has slowly increased over time. The frequencies of resistance among anaerobes in the B. fragilis group in the U.S.A. was 3 in 1987, and increased to 16 , 26 , and 43 in 1996, 2000, and 2003, respectively 15-18 . However, resistance at some locations reached 44 19 . Results from one medical center cannot predict those at other centers as resistance to clindamycin in...

Introduction to Anaerobes

Gram Stai Bilophila

Anaerobic bacteria differ in their pathogenicity. Not all of them are believed to be clinically significant, while others are known to be highly pathogenic. Table 1 lists the major anaerobes that are most frequently encountered clinically. The taxonomy of anaerobic bacteria has changed in recent years because of their improved characterization using genetic studies 1 . The ability to differentiate between similar strains enables better characterization of type of infection and predicted...

Effect of Iron Supplements

The iron content of the formula influences the number of Clostridium spp. in the large intestine of infants 57 . Clostridium tertium is more often isolated from breast-fed infants than from either group of bottle-fed infants, and Clostridium butyricum is more frequently recovered from infants bottle fed with iron supplement than from breast-fed infants or infants bottle fed without iron supplement. Enhancement of bacterial growth by iron has been recognized for some Clostridium spp. 58 C....

Bacteroides fragilis Group

Bacteroides Fragilis Group

B. fragilis group is the most prevalent bacteriodaceae isolated. B. fragilis is the most prevalent organism in the B. fragilis group, accounting for 41 to 78 of the isolates of the group. However, it should be remembered that the other members of the group account for the rest of the B. fragilis group isolates. The relative distribution of the different B. fragilis group has important clinical implications in the management of infections involving anaerobic bacteria. This is because of the...

Collection Transportation and Processing of Specimens for Culture

Transport Specimen For Culture Test

The perception that anaerobes have little or no role in many infections originates from the fact that many past studies did not attempt to identify such a role or used improper methods for collecting specimens for anaerobes. Therefore, carefully assessing studies for methodological properties before judging their ability to determine the role of anaerobes in an infectious process is essential. Multiple examples of differences in the rate of recovery of anaerobic bacteria between studies that...

Conjunctivitis And Dacryocystitis Conjunctivitis

Conjunctivitis in the newborn infant usually is due to chemical and mechanical irritation caused by the instillation of silver nitrate drops or ointment into the eye in order to prevent gonorrheal ophthalmia. Chemical conjunctivitis differs from infective forms in that it becomes apparent almost immediately after the instillation. The most common causes of infectious conjunctivitis in descending order of frequency are Chlamydia trachomatis, Neisseria gonorrhoeae, Staphylococcus spp., inclusion...

Virulence of Anaerobic Bacteria and the Role of Capsule

Most anaerobic infections are pyogenic and arise from the normal flora of the skin, oropharynx, the large intestine, or the female genital tract. Such infections typically involve multiple species of bacteria, some strict anaerobes, some strict aerobes and others that are facultative anaerobes i.e., able to grow aerobically or anaerobically . The polymicrobial nature of infections involving anaerobic bacteria is apparent in infections of the respiratory tract, abdomen, pelvis, and soft tissue,...