A Retrospective Review of Cases of Anaerobic Empyema and Update of Bacteriology

Abstract

We conducted a retrospective study to update the bacteriology of 46 cases of anaerobic empyema that were originally studied between 1976 and 1993 at the Wadsworth Anaerobic Bacteriology Clinical Research Laboratory (Los Angeles). Anaerobic bacteriologic studies were completed for all 46 pleural fluid specimens, and aerobic bacteriologic studies were completed for 41 of these specimens. Thirty-seven clinical charts were available for review. A total of 161 anaerobic isolates (3.5 per patient) representing 64 species or groups were recovered. The most common isolates were as follows: Fusobacterium nucleatum (19); Prevotella oris-buccae group (13, 9 of which were P. oris); Bacteroides fragilis group (11, 4 of which were B. fragilis); pigmented Prevotella species (17, 8 of which were in the Prevotella intermedia-nigrescens group); Peptostreptococcus species (17, 9 of which were Peptostreptococcus micros); Eubacterium species (7); Lactobacillus species (8); Actinomyces species (7); and Clostridium species (7). Nineteen if the cases were of purely anaerobic etiology; of these, eight were caused by a single organism: F. nucleatum (five cases); B. fragilis (two cases); and Prevotella mangus (one case). Of the 45 aerobic isolates (1.1 per patient), viridans streptococci were most common (21 isolates), followed by group D nonenterococcal streptococcus (four isolates). Only nine gram-negative rods (six enteric and three nonenteric organisms) and one Staphylococcus aureus isolate were recovered. The susceptibility to penicillin of 64 isolates was examined with the use of the spiral gradient method; 21 (33%) of these isolates were beta-lactamase positive (MICs ranged from 1.1 to > or = 54 micrograms/mL vs < or = 0.27 micrograms/mL for beta-lactamase-negative strains).

Isolation of Candida Species is an Important Clue for Suspecting Gastrointestinal Tract Perforation as a Cause of Empyema

“…In the preantibiotic era, Streptococcus pneumoniae accounted for 60% to 70% of cases and Streptococcus pyogenes for 10% to 15% of cases (1). S. pneumoniae now accounts for only 5% to 10% of cases, and many infections are mixed, with anaerobes present in 25% to 76% of empyemas either as the sole organisms or in combination with other aerobic or facultative organisms (2). Bartlett and Finegold (3) found that pleural empyema was caused by aerobic bacteria in 24%, anaerobic bacteria in 35%, and both aerobic and anaerobic bacteria in 41%.…”

Interactions between Periodontal Bacteria and Human Oral Epithelial Cells: Fusobacterium nucleatum Adheres to and Invades Epithelial Cells

“…Our findings revealed Fusobacterium nucleatum as a potentially important organism in periodontal infections. F. nucleatum is a filamentous human pathogen strongly associated with periodontal diseases (28) as well as infections and abscesses in other parts of the body (3,5,17). Several potential virulence mechanisms have been proposed for F. nucleatum (7,13,15,21,24,31,35,36,38).…”

In vitro antimicrobial susceptibility of anaerobic bacteria isolated from caprine footrot

“…Johnson et al (1990) drew attention to the growing resistance of Gramnegative bacilli to the β-lactam family of antimicrobials. Civen et al (1995) have reported an increasing involvement of Prevotella species in abscess-forming processes, possibly due to enhanced penicillin resistance over recent years.…”