Abstract Anaerobes are prevalent on all mucosal surfaces and virtually all anaerobic infections are endogenous. Two thirds of anaerobic infections involve five anaerobic organisms or groups—the Bacteroides fragilis group, the Bacteroides melaninogenicus-Bacteroides asaccharolyticus group, Fusobacterium nucleatum, the anaerobic cocci, and Clostridium perfringens. Conditions that lower the oxidation-reduction potential and disrupt the mucosal surface (eg, vascular problems, malignant neoplasms, and surgery) lead to infection with anaerobes. Clues to anaerobic infection include foul odor, gas, tissue destruction, underlying malignant neoplasms, and the unique appearance of certain anaerobes on Gram's stain. Specimens must be collected to avoid normal flora and transported to the laboratory under anaerobic conditions. Therapy involves surgical débridement and drainage and the use of various antimicrobial agents. Antimicrobial agents must be used for extended periods to avoid relapse. (Arch Intern Med 1982;142:1988-1992) References 1. Finegold SM: Anaerobic Bacteria in Human Disease . New York, Academic Press Inc, 1977, p 710. 2. Sutter VL, Citron DM, Finegold SM: Wadsworth Anaerobic Bacteriology Manual , ed 3. St Louis, CV Mosby Co, 1980, p 131. 3. Kasper DL, Finegold SM: Guest editors: Virulence factors of anaerobic bacteria. Rev Infect Dis 1979;1:245-400.Crossref 4. Anderson CB, Marr JJ, Ballinger WF: Anaerobic infections in surgery: Clinical review. Surgery 1976;79:313-324. 5. Balows A, DeHaan RM, Dowell VR Jr, et al (eds): Anaerobic Bacteria: Role in Disease . Springfield, Ill, Charles C Thomas Publisher, 1974, p 655. 6. Gorbach SL, Bartlett JG: Anaerobic infections. N Engl J Med 1974;290:1177-1184, 1237-1245, 1289-1294.Crossref 7. Saksena DS, Block MA, McHenry MC, et al: Bacteriodaceae: Anaerobic organisms encountered in surgical infections. Surgery 1968;63:261-267. 8. Swenson RM, Lorber B, Michaelson TC, et al: The bacteriology of intra-abdominal infections. Arch Surg 1974;109:398-399.Crossref 9. Willis AT: Clostridia of Wound Infection . Washington, DC, Butterworth Inc, 1969, p 490. 10. Finegold SM: Antimicrobial therapy of anaerobic infections: A status report. Hosp Pract 1979;14:71-81. 11. George WL, Sutter VL, Finegold SM: β-lactam antimicrobials for treatment of anaerobic infections: A review of in vitro activity and therapeutic efficacy , in Salton M, Shockman GD (eds): β-Lactam Antibiotics , New York, Academic Press, 1981, pp 493-530.
Archives of Internal Medicine – American Medical Association
Published: Oct 25, 1982