88 - Anaerobic Infections: A Clinical Overview

Abstract

Infections due to anaerobes are common and associated with considerable morbidity and potential mortality. The anaerobic bacteria responsible for disease in humans are to be found in the normal flora of humans and animals and in the environment. Because, in many cases, they are not immediately clinically distinguishable from many other infections, anaerobic infections may readily be overlooked and their diagnosis depends in the first place on a high level of clinical suspicion. If many or most of the anaerobes present are to be cultivated successfully, special precautions are necessary for specimen collection and transport. Though, in principle, the culture and identification of anaerobes is straightforward, the practice requires great attention to technical detail. Anaerobic infections may also be difficult to treat. Because many anaerobic bacteria are extremely sensitive to oxygen, proper transport involves placing the specimen into an oxygen-free glass tube or vial under anaerobic conditions in a nonnutritive holding medium for transport to the laboratory. Initial antimicrobial therapy is necessarily empirical, because it takes some time to obtain definitive information about the susceptibility of the infecting flora and antimicrobial agents. Antimicrobial resistance is an increasing problem with anaerobic bacteria, and the mechanisms for this resistance are similar to the mechanisms that are involved with nonanaerobes.