Iranian Journal of Microbiology 2016. 8(3):181-186.

Anaerobic infections in surgical wards –A two year study
Padmaja Ananth Shenoy, Shashidhar Vishwanath, Ryumzook Targain, Seema Shetty, Gabriel Sunil Rodrigues, Chiranjay Mukhopadhyay, Kiran Chawla

Abstract


Background and Objectives: Anaerobic bacteria are recognized as important pathogens in surgical infections. However, they are the most overlooked microorganisms by the clinic and the laboratory because of the tedious culture techniques with longer turn-around times. The study was aimed to analyze the frequency of anaerobic bacterial surgical infections and their predisposing factors.

Materials and Methods: A retrospective study was conducted over a period of two years including patients with surgical infections. The specimens were processed by Gram staining, aerobic and anaerobic culture. The anaerobic bacteria were isolated using standard procedures. The predisposing factors and clinical presentation were studied in these patients.

Results: A total of 261 specimens were received from patients with diverse infections from surgical wards. Ninety-one anaerobes were isolated from 64 (24.5%) surgical patients with a predominance of Gram-negative bacilli (37.4%). Anaerobic bacteria as monomicrobial isolates were seen in 21.9% isolates. Anaerobic bacterial isolation along with aerobic bacteria was seen in 71.9% of patients and polymicrobial anaerobic growth was detected in 6.3% of patients. Diabetes mellitus (28, 43.8%) was found to be the most frequent predisposing factor. Bacteroides fragilis group (20.9%) were the most frequent anaerobic Gram-negative bacilli followed by Prevotella spp. (12.1%). Peptostreptococcus anaerobius was the predominant anaerobic cocci isolated (14.3%). Necrotizing fascitis (34.4%) was the most common clinical presentation with anaerobic etiology followed by deep seated abscesses (23.4%).

Conclusion: Anaerobic bacteria were isolated from a significant proportion of surgical infections. To avoid therapeutic failures, anaerobic bacteria in surgical infections need to be recognized by surgeons and laboratorians.


Keywords


Anaerobic bacteria; Gram negative bacilli; Polymicrobial; Surgical infections

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References


Finegold SM. Overview of clinically important anaer- obes. Clin Infect Dis 1995; 20:S205-207.

Edmiston CE Jr, Krepel CJ, Seabrook GR, Jochim- sen WG. Anaerobic infections in the surgical patient: Microbial etiology and Therapy. Clin Infect Dis 2002;35:S112-118.

Kamble S, Pol S, Jose T, Gore V, Kagal A, Bharadwaj R. The prevalence of anaerobes from cutaneous and subcutaneous wound infections. Indian J Basic Appl Med Res 2014; 3:371-378.

Finegold SM (2000). Anaerobic bacteria: General con- cepts. In: Mandell, Douglas and Bennett’s principles and practice of infectious diseases. Ed, GL Mandell, JE Bennet, R Dolin. Churchill Livingstone, 5th ed. Phila- delphia, pp. 2519-2537.

Jamal W, Al Hashem G, Rotimi VO. Antimicrobial re- sistance among anaerobes isolated from clinical speci- mens in Kuwait hospitals: Comparative analysis of 11- year data. Anaerobe 2015; 31:25-30.

Saini S, Gupta N, Aparna, Lokveer, Griwan MS. Sur- gical infections: A Microbiological study. Braz J Infect Dis 2004; 8:118-125.

Mathew A, Mridula M, Vishwanath S, Mukhopadhyay C, Rodrigues G. Clinico-microbiological profile of necrotizing fasciitis secondary to diabetes mellitus in a tertiary care hospital. Webmed Central General Sur- gery 2010; 1(12):WMC001399.

Bessman AN, Wagner W. Non clostridial gas gangrene: A report of 48 cases and review of literature. JAMA 1975; 233:958-963.

De A, Gogate A. Prevalence of Gram negative an- aerobic bacilli in routine clinical specimens. Indian J Pathol Microbiol 2001; 44:435-438.

Garg R, Kaistha N, Gupta V, Chander J. Isolation, iden- tification and antimicrobial susceptibility of anaerobic bacteria: A study re-emphasizing its role. J Clin Diagn Res 2014; 8:DL01-DL02.

Collee JG, Miles RS, Watt B (1996). Tests for identifi- cation of bacteria. In: Mackie and McCartney Practical Medical Microbiology. Ed, JG Collee, AG Fraser, BP Marmion, A Simmons. Churchill Livingstone, 14th ed. New York, pp. 131-150.

Jousimies-Somer H, Summanen P, Citron DM, Baron EJ, Wexler HM, Finegold SM (2002). Wadsworth-KTL anaerobic bacteriology manual. 6th ed. Star Publishingompany. California.

Bowler PG, Duerden BI, Armstrong DG. Wound mi- crobiology and associated approaches to wound man- agement. Clin Microbiol Rev 2001; 14:244-269.

Lofmark S, Edlund C, Nord CE. Metronidazole is still the drug of choice for treatment of anaerobic infections. Clin Infect Dis 2010; 50:S16-S23.

Akhi MT, Ghotaslou R, Beheshtirouy S, Asgharzadeh M, Pirzadeh T, Asghari B, et al. Antibiotic susceptibil- ity pattern of aerobic and anaerobic bacteria isolated from surgical site infection of hospitalized patients. Jundishapur J Microbiol 2015; 8:e20309.

Elliott D, Kufera JA, Myers RA. The microbiology of necrotizing soft tissue infections. Am J Surg 2000;179:361-366.

Mousa HA. Aerobic, anaerobic and fungal burn wound infections. J Hosp Infect 1997; 37:317-323.

Liu C, Song Y, McTeague M, Vu AW, Wexler H, Fine- gold SM. Rapid identification of the species of the Bac- teroides fragilis group by multiplex PCR assays using group- and species-specific primers. FEMS Microbiol Lett 2003; 222:9-16.

Wexler HM. Bacteroides: the good, the bad, and the nitty-gritty. Clin Microbiol Rev 2007; 20:593-621.

Brook I, Frazier EH. Clinical and microbiological fea- tures of necrotizing fasciitis. J Clin Microbiol 1995;33:2382-2387.

Brook I. Aerobic and anaerobic microbiology of in- fections after trauma in children. J Accid Emerg Med 1998; 15:162-167.

Brook I, Frazier EH. Aerobic and Anaerobic microbi- ology of chronic venous ulcers. Int J Dermatol 1998;37:426-428.

Bowler PG, Davies BJ. The Microbiology of infect- ed and noninfected leg ulcers. Int J Dermatol 1999;38:573-578.

Murphy EC, Frick IM. Gram-positive anaerobic coc- ci-commensals and opportunistic pathogens. FEMS Microbiol Rev 2013; 37:520-553.

Gorbach SL, Thadepalli H. Isolation of Clostridium in human infections: evaluation of 114 cases. J Infect Dis 1975; 131:S81-85.

Nichols RL, Smith JW. Anaerobes from a surgical per- spective. Clin Infect Dis 1994; 18:S280-286.

Anderson CB, Marr JJ, Ballinger WF. Anaerobic infec- tions in surgery: clinical review. Surgery 1976; 79:313-324.


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