Population-based assessment of the incidence, risk factors, and outcomes of anaerobic bloodstream infections

Ngo, Jennifer; Parkins, Michael D.; Gregson, Dan; Pitout, Johann; Ross, Terry; Church, Deirdre L.; Laupland, Kevin B.

doi:10.1007/s15010-012-0389-4

Cited by 78 publications

(55 citation statements)

References 27 publications

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“…In addition to the previous observations, the analysis of the MIC of Metronidazole shows that, as reported by other authors, the anaerobic intestinal flora is always sensible to the therapy and to the prophylaxis with this drug, while the anaerobic flora which is prevalent on skin and other mucosae (P. acnes, P. micros, L. acidophilus) is resistant (1,3). These observations prompt us to conclude, in agreement with other authors, that bacteremia caused by anaerobic microorganisms develop in conditions that are connected with age, as well as pathological conditions such as blood dyscrasias and alterations of tissue microcirculation, which render the subject more susceptible to this kind of infection (9,11). We cannot moreover exclude the possibility that, especially considering the high frequency of cultures positive to P. acnes, the anaerobes found be acting as a contaminating microorganism (5,10).…”

Section: Discussionsupporting

confidence: 88%

“…We can confirm, in agreement with the current literature, that most cases of sepsis are caused by bacteria of the Bacteroides genus, whose habitat is prevalently the intestines. Following cases of sepsis caused by Bacteroides, we found a high incidence of events caused by P. acnes, a microorganism found mostly on skin, conjunctiva, oral cavity, and less frequently in the intestinal tract (8,9,11). In the cases we observed, those patients who develop sepsis by anaerobes are mostly staying in the Medical Area, while we saw only a small percentage of cultures positive to anaerobes in the Surgical area.…”

Section: Discussionmentioning

confidence: 99%

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Bacteremia due to anaerobic bacteria: epidemiology in a northern Bari Hospital, Italy

et al. 2015

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SummaryBackground. 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 Propionibacterium acnes, 1 Peptosctreptococcus micros, 1 Lactobacillus acidophilus, 1 Clostridium perfringens, 1 Prevotella oralis, 1 Eubacterium lentum.Conclusions. The analysis of the results suggests that the incidence of cultures positive to anaerobia was constant across the years. We note that advanced age, altered mucocutaneous tropism, alterations to the oral and intestinal bacterial flora intensify the risk of anaerobial pathogenicity. The analysis of the metronidazole-determined MIC suggests that the intestinal anaerobic flora responds well to therapy and prophylaxis with Metronidazole, while the anaerobic bacteria residing on skin and other mucosae are resistant. It is however hard to determine the clinical impact of anaerobic bacteremiae and their effect on the outcome of the patient, due to the scarcity of available clinical data.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Bacteremia due to anaerobic bacteria: epidemiology in a northern Bari Hospital, Italy

et al. 2015

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“…Anaerobes as a group are frequently observed causes of community-onset BSI (2-5). Ngo and colleagues reported on all anaerobic BSIs in Calgary during 2000 to 2008 and found incidence rates of 3.6 and 2.9 per 100,000 for communityassociated and health care-associated community-onset BSIs, respectively (176). Bacteroides fragilis is the most commonly observed anaerobic species causing community-onset BSI, with reported rates (per 100,000 per year) of 2.4 in Calgary, Canada, from 2000 to 2004 (4), and 2.1 in Victoria, Canada, from 1998 to 2005 (5).…”

Section: Specific Etiologiesmentioning

confidence: 99%

Population-Based Epidemiology and Microbiology of Community-Onset Bloodstream Infections

2014

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SUMMARY Bloodstream infection (BSI) is a major cause of infectious disease morbidity and mortality worldwide. While a positive blood culture is mandatory for establishment of the presence of a BSI, there are a number of determinants that must be considered for establishment of this entity. Community-onset BSIs are those that occur in outpatients or are first identified <48 h after admission to hospital, and they may be subclassified further as health care associated, when they occur in patients with significant prior health care exposure, or community associated, in other cases. The most common causes of community-onset BSI include Escherichia coli , Staphylococcus aureus , and Streptococcus pneumoniae . Antimicrobial-resistant organisms, including methicillin-resistant Staphylococcus aureus and extended-spectrum β-lactamase/metallo-β-lactamase/carbapenemase-producing Enterobacteriaceae , have emerged as important etiologies of community-onset BSI.

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“…All four patients exhibited risk factors for bacteremia with anaerobic bacteria to some degree; age in all cases, malignancy in one case, and in the cases of the two patients with excessive alcohol consumption, it is plausible that they suffered from some degree of chronic liver disease, which is a known risk factor for anaerobic bacteremia (10).…”

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confidence: 93%

Four Cases of Bacteremia Caused by Oscillibacter ruminantium, a Newly Described Species

et al. 2014

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The genus Oscillibacter has been known since 2007, but no association to human infection has been reported. Here, we present four cases of Oscillibacter ruminantium bacteremia from hospitals across Denmark from 2001 to 2010. Correct identification is now possible, as the 16S rRNA gene sequence was recently made publicly available. CASE REPORTSC ase 1 (year 2001) is a 53-year-old man who was admitted to the medical department with nausea and diarrhea, with a previous medical history of insulin-dependent diabetes mellitus, alcohol dependency, and chronic pancreatitis. On admittance, his temperature was 35.6°C and his blood pressure was 70/50 mm Hg. The total leukocyte count was 32.3 ϫ 10 9 cells/liter (normal value range, 3.5 ϫ 10 9 to 8.8 ϫ 10 9 ), and the C-reactive protein level was 169 mg/liter (normal value, Ͻ10 mg/liter). Blood cultures were drawn and antibiotic treatment was initiated with intravenous benzylpenicillin, gentamicin, and metronidazole. After 1 day of incubation, blood cultures (Bactec Plus aerobic/F vial and Bactec 9240 automated instrument; Becton, Dickinson Diagnostic Instrument Systems, Franklin Lakes, NJ, USA) were positive with coagulase-negative staphylococci, and the following day, after 45 h of incubation, the anaerobic vial (Bactec Plus anaerobic/F) showed growth of anaerobic Gram-negative rods. Benzylpenicillin was discontinued in favor of intravenous cefuroxime.The patient became afebrile but developed diffuse abdominal pains. A computerized tomography scan of his abdomen showed pancreatic calcifications and small quantities of peritoneal ascites. New blood cultures drawn were negative, and antibiotics were discontinued after a total of 10 days of treatment. The patient subsequently developed a large pleural effusion, but successful pleuracentesis could not be performed and the patient succumbed.The Gram-negative rods isolated from the first set of blood cultures were sent to an anaerobe reference laboratory and identified using conventional anaerobic identification methods (1) as a possible Clostridium species.Case 2 (year 2002) is a 78-year-old man who was admitted to the department of medicine with fatigue and epistaxis and with a previous medical record of ulcerative colitis, a mechanical aortic valve due to severe aortic stenosis, and hemicolectomy, including sigmoidectomy due to colon adenocarcinoma. The C-reactive protein level was 121 mg/liter, and the erythrocyte sedimentation rate was elevated to 110 (normal value, 0). The total blood leukocyte count was not elevated, and he was afebrile. Blood cultures drawn on admittance were without growth. The patient was diagnosed with a relapse of the colonic adenocarcinoma with metastasis to the liver and discharged 20 days later. Blood cultures (Bactec Plus anaerobic/F vial) drawn 1 day prior to discharge showed growth of anaerobic Gram-negative rods. The isolate was sent to an anaerobe reference laboratory and identified as a possible Clostridium sp. by using conventional anaerobic identification methods (1). To our knowledge, the...

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Population-based assessment of the incidence, risk factors, and outcomes of anaerobic bloodstream infections

Cited by 78 publications

References 27 publications

Bacteremia due to anaerobic bacteria: epidemiology in a northern Bari Hospital, Italy

Bacteremia due to anaerobic bacteria: epidemiology in a northern Bari Hospital, Italy

Population-Based Epidemiology and Microbiology of Community-Onset Bloodstream Infections

Four Cases of Bacteremia Caused by Oscillibacter ruminantium, a Newly Described Species

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