Journal List > Infect Chemother > v.41(4) > 1075466

Park, Lee, Kim, Choi, Yong, Jeong, Kim, Lee, and Chong: Recent Trends of Anaerobic Bacteria Isolated from Clinical Specimens and Clinical Characteristics of Anaerobic Bacteremia

Abstract

Background

Anaerobic bacteria can cause various infections, and their incidence may differ greatly, depending on the country or hospital. We investigated recent trends in anaerobe isolation and clinical characteristics of anaerobic bacteremia in one hospital in Korea to facilitate diagnosis and treatment of anaerobic infections.

Materials and Methods

Anaerobic bacteria isolated from blood, body fluids and abscess specimens at a university hospital in Korea during 2007 and 2008 were analyzed. The medical records of 82 anaerobic bacteremia patients were reviewed. A retrospective cohort study was conducted to determine the risk factors for in-hospital mortality of patients with anaerobic bacteremia.

Results

A total of 289 non-duplicated anaerobic isolates were recovered from blood, body fluids and abscess specimens. Bacteroides fragilis (73 isolates, 25.3%) was the most common organism followed by Clostridium perfringens (22 isolates, 7.6%), Peptoniphilus asaccharolyticus (21 isolates, 7.3%) and Anaerococcus prevotii (19 isolates, 6.6%). Eighty-four isolates were recovered from blood specimens, among which B. fragilis (24 isolates) and C. perfringens (21 isolates) were the most frequently isolated organisms. Among the 196 underlying diseases of anaerobic bacteremia patients, neoplastic, infectious, and gastrointestinal diseases accounted for 54 (27.6%), 46 (23.5%), and 41 (20.9%) cases, respectively. The alimentary tract was the most common suspected portal of entry. The in-hospital mortality rate of anaerobic bacteremia patients was 34.2%, and neutropenia at the time of blood culture was the only statistically significant factor associated with mortality in this study. Anaerobes were isolated in 1.4% of all positive blood cultures.

Conclusions

B. fragilis and C. perfringens are expected to be commonly isolated from clinical specimens. Despite its low prevalence, anaerobic bacteremia displays a significant in-hospital mortality rate. Ongoing investigations into anaerobic bacteremia are necessary because of ambiguous risk factors for mortality.

Figures and Tables

Table 1
Distribution of Anaerobic Bacterial Strains Isolated from Various Clinical Specimens in a Single Korean Hospital in 2007 and 2008
ic-41-216-i001

*One Clostridium innocuum and one B. fragilis isolates were recovered from the same patient

One F. nucleatum and one B. fragilis isolates were recovered from the same patient

Table 2
Site of infection and the Genus of Anaerobic Bacteria Isolated from the Blood
ic-41-216-i002

Abbreviations: GNR, gram-negativerod; GPC, gram-positive cocci; GPR, gram-positive rod

*Includes Prevotella and Fusobacterium species

Includes Clostridium and Actinomyces species

Table 3
Aerobic Bacteria Concomitantly Isolated with Anaerobes from the Blood
ic-41-216-i003

Abbreviations: GNR, gram-negative rod; GPC, gram-positive cocci; GPR, gram-positive rod

*Includes Prevotella and Fusobacterium species

Table 4
Demographics and Factors Associated with In-hospital Mortality in 79 Patients with Anaerobic Bacteremia
ic-41-216-i004

Abbreviations: CI, confidence interval; NA, not applicable

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