Abstract • The aerobic and anaerobic microbiologic characteristics of 584 wounds and 676 skin or soft-tissue abscesses were studied and correlated with the infection site. In wounds, aerobic or facultative bacteria only were present in 223 specimens (38%), anaerobes only in 177 specimens (30%), and mixed flora in 184 specimens (32%). In total there were 1470 isolates, 558 aerobic and 912 anaerobic, an average of 2.5 isolates per wound (1.6 anaerobic and 0.9 aerobic isolates). In abscesses, aerobic or facultative bacteria were recovered in 177 specimens (26%), anaerobes only in 243 specimens (36%), and mixed flora in 256 specimens (38%). In total there were 1702 isolates, 602 aerobic and 1100 anaerobic, an average of 2.5 isolates per abscess. The highest rates of anaerobes in wounds were in the inguinal, buttocks, and trunk areas and in abscesses in the perirectal, external genitalia, neck, and inguinal areas. The predominant aerobic organisms were Staphylococcus aureus (363 isolates), group A streptococci (98 isolates), and Escherichia coli (97 isolates). The predominant anaerobic organisms were Bacteroides species (986 isolates), Peptostreptococcus species (559 isolates), Clostridium species (153 isolates), and Fusobacterium species (109 isolates). The predominance of certain isolates in certain anatomical sites was correlated with their distribution in the normal flora adjacent to the infected site. These data highlight the polymicrobial nature of wounds and cutaneous abscesses. (Arch Surg. 1990;125:1445-1451) References 1. Meislin HW, Lerner SA, Graves MH, et al. Cutaneous abscesses: anaerobic and aerobic bacteriology and outpatient management . Ann Intern Med . 1977;97:145-150.Crossref 2. Brook I, Finegold SM. Aerobic and anaerobic microbiology of cutaneous abscesses in children . Pediatrics . 1981;67:891-895. 3. Ghoneim ATM, McGoldrick J, Blick PWH, Flowers MW, Marsden AK, Wilson OH. Aerobic and anaerobic bacteriology of subcutaneous abscesses . Br J Surg . 1981;68:498-500.Crossref 4. Kontiainen S, Rinne E. Bacteria isolated from skin and soft tissue lesions . Eur J Clin Microbiol Infect Dis . 1987;6:420-422. 5. Holdeman LV, Cato EP, Moore WEC, eds. Anaerobe Laboratory Manual . 4th ed. Blacksburg, Va: Virginia Polytechnic Institute and State University; 1977. 6. Sutter VL, Citron DM, Edelstein MAC, Finegold SM. Wadsworth Bacteriology Manual . 4th ed. Belmont, Calif: Star Publishing Co; 1985. 7. Lennette EH, Balows A, Hausler WJ, Shadomy CH. Manual of Clinical Microbiology . 4th ed. Washington, DC: American Society for Microbiology; 1985. 8. Gibbons RJ. Aspects of the pathogenicity and ecology of the indigenous oral flora of man . In: Ballow A, ed. Anaerobic Bacteria: Role in Disease . Springfield, Ill: Charles C Thomas Publisher; 1974. 9. Gorbach SL. Intestinal microflora . Gastroenterology 1977;60:1100-1129. 10. Brook I. Bacteriology of paronychia in children . Am J Surg 1981;141:703-705.Crossref 11. Brook I. Enhancement of growth of aerobic and facultative bacteria in mixed infections with Bacteroides species . Infect Immun . 1985;50:929-931. 12. Altemeir WA. The pathogenicity of the bacteria of appendicitis . Surgery . 1942;11:374-378. 13. Brook I, Hunter V, Walker RI. Synergistic effects of anaerobic cocci, Bacteroides, clostridia, fusobacteria, and aerobic bacteria on mouse mortality and induction of subcutaneous abscess . J Infect Dis . 1984;149:924-928.Crossref 14. Tofte RW, Peterson PK, Schemling D. Opsonization of four Bacteroides species: role of the classical complement pathway and immunoglobulin . Infect Immun . 1980;27:784-792. 15. Lev M, Drudell DC, Milford AF: Succinate as a growth factor for Bacteroides melaninogenicus . J Bacteriol . 1971;108:175-178. 16. Mergenhagen SE, Thonard JC, Scherp HW. Studies on synergistic infection, I: experimental infection with anaerobic streptococci . J Infect Dis . 1958;103:33-44.Crossref 17. Brook I. Pediatric Anaerobic Infection: Diagnosis and Management . St Louis, Mo: CV Mosby Co; 1989. 18. Finegold SM. Anaerobic Bacteria in Human Disease . Orlando, Fla: Academic Press Inc; 1977. 19. Aldridge KE, Sanders CV, Janney A, Faso S, Marier RL. Comparison of activities of penicillin G and new beta-lactam antibiotics against clinical isolates of Bacteroides species . Antimicrob Agents Chemother . 1984;26:410-413.Crossref 20. Tally FP, Cuchural GJ, Jacobus NV, et al. Susceptibility of the Bacteroides fragilis group in the United States in 1981 . Antimicrob Agents Chemother . 1983;23:536-540. 21. Brougault AM, Rosenblatt JE, Fitzgerald RH. Peptococcus magnus: a significant pathogen . Ann Intern Med . 1980;93:244-248.Crossref 22. Brook I, Walker RI. Pathogenicity of anaerobic gram-positive cocci . Infect Immun . 1984;45:320-324.
Archives of Surgery – American Medical Association
Published: Nov 1, 1990
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