Incidence and Clinical Significance of Anaerobic Bacteremia in a Community Hospital (original) (raw)

Retrospective analysis of two hundred and twelve cases of bacteremia due to anaerobic microorganisms

European Journal of Clinical Microbiology, 1985

Cases of bacteremia caused by anaerobic microorganisms and occurring during a four year period in a non-selected patient group in a Spanish general hospital were analysed retrospectively. Microbiological data was collected on 212 patients and clinical data on 103 patients. Cases of anaerobic bacteremia represented 8.6 % of the total number of cases of bacteremia. Of the 232 anaerobic microorganism causing bacteremia, gram-negative bacilli were responsible in 113 cases (48.7 %), gram-positive bacilli in 92 cases (39.6 %), grampositive cocci in 25 cases (10.7 %), and Veillonella spp. in two cases (0.8 %). The most important clinical features were fever (64 %), anemia (56 %), septic shock (22 %) and metastatic abscesses (21%). Patients with anaerobic bacteremia were hospitahzed for an average of 51.7 days. The overall mortality was 32 % and factors associated with poor prognosis were severe underlying disease, nosocomial acquisition, presence of shock, presence of metastatic loci of infection, and absence of adequate surgical drainage. The mortality rate of patients who received adequate antimicrobial therapy was 30 % and that of patients who received inadequate treatment or none was 29 %. It is concluded that anaerobic bacteremia has a significant rate of morbidity and mortality and that undedying disease and surgical debridement and/or drainage have greater prognostic significance than the use of antimierobial agents.

Community-acquired anaerobic bacteremia in adults: one-year experience in a medical center

Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi, 2005

A prospective observational study was conducted to evaluate the clinical characteristics and outcome of community-acquired anaerobic bacteremia. From June 1 2001 through May 31 2002, 52 patients with community-acquired anaerobic bacteremia were enrolled at the emergency department in a teaching hospital. There were 19 patients (34%) with polymicrobial bacteremia and Escherichia coli was the most common copathogen (n = 6). Of 62 anaerobic isolates, species of the Bacteroides fragilis group were the most common isolates (n = 28, 45%), followed by Clostridium spp. (n = 11, 18%). Among the 52 patients enrolled, up to 27% had underlying malignancy and the gastrointestinal tract accounted for 48% of the sources of infection. Clinical manifestations suggesting anaerobic infections were common and three-quarters (n = 39) of 52 patients received adequate empirical antimicrobial treatment. Documentation of anaerobic bacteremia seldom influenced antimicrobial treatment. The 30-day mortality wa...

Clinical Significance and Outcome of Anaerobic Bacteremia

Clinical Infectious Diseases, 1998

We retrospectively studied the incidence of anaerobic bacteremia during 6 years (1991-1996) at Turku University Central Hospital (Turku, Finland). The clinical significance of a positive anaerobic blood culture, the effect of a positive culture on the choice of antimicrobial therapy, and the outcome for patients were evaluated. Cultures of blood from 81 patients yielded anaerobic bacteria (4% of all bacteremias). Anaerobic bacteremia was clinically significant in 57 patients (0.18 cases per 1,000 admissions). Only half (28) of these patients received appropriate and effective antimicrobial treatment before the results of blood cultures were reported; for 18 patients (32%), initially ineffective treatment was changed on the basis of the bacteriologic results, and for 11 patients (19%), the treatment was not changed. The mortality in these patient groups was 18%, 17%, and 55%, respectively. Empirical therapy may provide coverage for anaerobes in only half of the patients with anaerobic bacteremia, and failure to pay attention to the results of anaerobic blood cultures may have serious consequences for patients.

Bacteremia due to Enterobacter spp. in cancer patients—analysis of 51 episodes

International Journal of Antimicrobial Agents, 1997

Fifty one episodes of bacteremia due to Enterobacter spp. appearing within 7 years among 12 301 admissions in a single cancer institution were studied for risk factors, clinical presentation and outcome. Fifteen episodes were due to Enterobacter aerogenes, 23 due to E. cloacae and 13 due to E. agglomerans. The proportion of bacteremia due to Enterobacter spp. among Gram-negative bacteremias was 10.1% and infection associated mortality was 13.8%. The incidence in 1989 -1995 varied from 3.7 to 8.7% and was relatively stable. Most common risk factors were: solid tumors as underlying disease, central venous catheter insertion, prior surgery and prior chemotherapy within 48 h. Neutropenia and urinary catheters were not at high risk in either one of the patients subgroups. Comparing two subgroups of 51 bacteremias, monomicrobial and polymicrobial (when Enterobacter spp. was isolated from blood culture with other microorganism), previous chemotherapy, vascular catheter insertion and prior endoscopy were more frequently associated with polymicrobial Enterobacter spp. bacteremia. There was also differences in infection associated mortality: bacteremias due to Enterobacter spp. only had significantly lower mortality in comparison to polymicrobial Enterobacter spp. bacteremias (3.3 vs. 29.3%; P B0.02). Susceptibility of Enterobacter spp. strains isolated from 51 episodes was stable and showed only two episodes due to quinolone-resistant strains, both in 1992 despite of the use of ofloxacin in prophylaxis of neutropenic patients since 1990 in our institute. Ninety-two to 94% of all strains were susceptible to aminoglycosides, 96 -98% to ofloxacin and ciprofloxacin, respectively and 94.9% to meropenem but only 75.5% to ceftazidime. © 1997 Elsevier Science B.V.

Enterobacteriaceae bacteremias among cancer patients: an observational cohort study

2013

Background: Enterobacteriaceae bacteremia is a common complication in patients with neoplasm. The cancer itself, chemotherapy-induced immunosuppression, and other cancer-related procedures play a role as predisposing factors for this condition. However, despite the clear association between cancer and Enterobacteriaceae bacteremia, the distinctive clinical characteristics of patients with cancer presenting with Enterobacteriaceae bacteremia have not been well established. Methods: The population studied was a prospective cohort of adult hospitalized patients with Enterobacteriaceae bacteremia in a tertiary care hospital. We compared the clinical variables and microbiological features between patients with an underlying neoplasm (n = 203) and those without (n = 259). STATA software was used for statistical association analysis. Results: In a bivariate analysis, older age, prior exposure to aminopenicillins, fewer days of symptoms, biliary source of bacteremia, greater severity of APACHE II score, lower white blood cell and platelet counts, and the presence of Klebsiella pneumoniae were more common in the neoplasm group. In a multivariable analysis, K. pneumoniae bacteremia (odds ratio (OR) 6.13, 95% confidence interval (CI) 1.65-22.71; p = 0.007), APACHE II score (OR 1.18, 95% CI 1.05-1.34; p = 0.007), and exposure to aminopenicillins (OR 28.84, 95% CI 1.94-429.3; p = 0.015) were associated with neoplasm. K. pneumoniae bacteremia was more commonly present in patients with lung and gastrointestinal cancers. Conclusions: We have confirmed the association of K. pneumoniae bacteremia with underlying neoplastic disease, especially with gastrointestinal malignancies, which may allow stratification for initial empiric antibiotic therapy in this subset of patients. Prior exposure to aminopenicillins in the neoplasm group might contribute to this finding. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

Bacteremia due to anaerobic bacteria: epidemiology of a north of Bari hospital

Microbiologia Medica, 2015

Background. Anaerobic bacteria are part of the commensal bacterial flora of skin and mucosae. Iatrogenic and pathological conditions altering this commensal relationship cause life-threatening diseases. Materials and Methods. We analysed the blood cultures sent to the microbiology of our hospital between 2008 and the first quarter of 2013 to measure the frequency of bacteraemia caused by anaerobia. We examined 3138 vials of blood cultures for anaerobia, inoculated following in-house standard procedures. The colonies grown in absence of air were subjected to biochemical analysis. The MICs of metronidazole for 23 of the 26 organisms was tested. Results. Twelve bacteria of the Bacteroides genus were identified, 9

Anaerobic infections in surgical wards: a two year study

Iranian journal of microbiology, 2016

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. 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. 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...