A range of anaerobic bacteria may be pathogenic to man. Those of particular clinical significance are reviewed and prospects for their control by antibiotic therapy discussed.

Bacteria, Anaerobic↗

PubMed1985

John Herbertson Bowie. 1 August 1909--15 April 1984.

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Bacteriology↗

PubMed1985

The role of Robertson's cooked-meat broth in the bacteriological evaluation of surgical specimens.

The results were compared of submitting simple swabs, swabs in Stuart's Transport Medium (STM) and swabs in Robertson's cooked-meat broth (RCMB), from 100 potentially or definitely infected sites in patients undergoing general surgery. Significantly more positive bacterial cultures were obtained from swabs sent in RCMB (65), than from swabs sent either in STM (39) or as simple swabs (32). The isolation of potentially significant organisms from only the RCMB series could influence clinical management. The conventional reluctance of bacteriologists to accept evidence obtained from RCMB cultures seeded directly in the ward or at operation is challenged.

Abscess↗

PubMed1985

Concepts of anaerobic infection in relation to prevention and management.

Concepts of anaerobic infection are reviewed in relation to the management of wounds that might be contaminated by facultative or anaerobic organisms or mixtures of these. Considerations of post-operative wound infections oblige us to consider the indications for per-operative antimicrobial prophylaxis and to bear in mind the role of anaerobes and the possibility of pathogenic synergy in these situations. Pathogenic associations of anaerobes with other organisms are further considered in relation to periodontal disease and anaerobic vaginosis. The various roles of anaerobes in enteropathogenic conditions are briefly considered. There is a continuing obligation on clinical bacteriologists and clinicians to work together towards the more effective prevention and management of infections that may or may not have a significant anaerobic component.

Adult↗

PubMed1984

Immunochemical fingerprinting of Clostridium difficile strains isolated from an outbreak of antibiotic-associated colitis and diarrhoea.

Twenty eight strains of Clostridium difficile , isolated from an outbreak of antibiotic-associated colitis and diarrhoea in an orthopaedic ward and from sporadic cases throughout Sweden, were sent to Edinburgh for immunochemical fingerprinting without information about their origin. EDTA extracts of the organisms were examined by crossed immunoelectrophoresis (CIE), polyacrylamide gel electrophoresis (PAGE) and electroblot transfer. Two patterns were revealed by CIE: group A (18 strains) and group B (10 strains). PAGE and electroblot transfer revealed one major group of 10 strains (group 1), six small groups of two or three strains and six strains which were unlike any other strain. The CIE group B and PAGE- electroblot group 1 were identical. Nine of the 10 strains in this group were from patients in the outbreak. These findings indicate that a single strain spread in the orthopaedic ward as a nosocomial infection and that this strain differed from most other strains investigated. The PAGE- electroblot technique should, therefore, greatly aid investigations into the epidemiology of C. difficile infections.

Anti-Bacterial Agents↗

PubMed1982

Clostridium difficile in association with sporadic diarrhoea.

A total of 154 patients admitted to an infectious diseases unit were included in a year's prospective survey of sporadic diarrhoeal disease. Stools from 19 of them yielded Clostridium difficile, generally on more than one occasion. Twelve of these patients were assessed as having a severe or moderately severe gastrointestinal illness: Cl difficile was the only pathogen isolated from 10 of them, and two had an associated salmonella infection. Seven had had a recent course of antibiotics, but five had not taken antibiotics. Faeces from seven patients with moderate or mild gastrointestinal illness yielded Cl difficile, and two of these patients also had an associated salmonella infection. Two patients in this group had no antibiotic history. From these findings, the occurrence of C difficile in faeces could not be described as antibiotic-associated. Faecal Cl difficile cytotoxin was detected in only six patients, and generally at low levels. In such patients a more relevant pathogenic index might take account of the numbers of Cl difficile present and of their toxigenic potential.

Adult↗

PubMed1982

The role of anaerobes and possible indications for anti-anaerobe chemotherapy in infections of the head, neck and thorax.

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Actinomycosis↗

PubMed1982

Detection of species-specific and cross-reactive cell-surface antigens of Bacteroides species by an indirect enzyme-linked immunosorbent assay.

EDTA-released outer-membrane antigen complexes were prepared from 172 laboratory and reference strains and 43 fresh clinical or faecal isolates representing 20 species or subspecies of Bacteroides, together with 13 species of other genera. These antigens were titrated against antisera to whole, live cells of 21 species or subspecies of Bacteroidaceae in an indirect enzyme-linked immunosorbent assay (ELISA). The presence of species-specific antigens was investigated and cross reactions between species were noted. Results showed that a high proportion of the species possess species-specific antigens with little significant cross reactivity. We believe that the ELISA system described here detects antigens that represent the whole cell surface of bacteroides organisms. We have exploited the sensitivity of the system and its quantitative potential to define approaches for those wishing to use serological approaches for either the identification of Bacteroides species or for the titration of serum antibodies in patients with a possible bacteroides infection.

Antigens, Bacterial↗

PubMed1982

Current approaches to the classification, characterisation and typing of pathogenic anaerobic bacteria.

Characterisation systems based on the demonstration of soluble antigens and toxins are of much practical value but have clear taxonomic limitations. This is illustrated by reference to our work with some of the pathogenic clostridia. The definition and classification of the anaerobic cocci is a difficult and continuing challenge. Systems for the classification and characterisation of the gram-negative non-sporing anaerobic bacilli are evolving well, though there are still some very difficult areas. A selection of the most helpful tests is indicated. Biotyping systems are compared with serotyping systems; the results of serological approaches to characterisation are encouraging. The further exploration of bacteriocin typing seems to be merited. The challenge of characterisation and classification of anaerobic spirochaetes commonly involved in human infections must now be taken up.

Amino Acids↗

PubMed1980

Mechanisms of pathogenicity of anaerobic bacteria of clinical interest.

The host factors leading to anaerobic infection and the various models of anaerobic infection, namely direct effect of a single toxin, multiple toxin-aggressin-systems, enterotoxic mechanisms, endogenous infections with non-clostridial anaerobes, and synergistic infections, are reviewed. Production of carcinogens and co-carcinogens by anaerobes is also discusssed.

Anaerobiosis↗

PubMed1980

Factors contributing to loss of anaerobic bacteria in transit from the patient to the laboratory.

Care and attention to detail in the sampling, transit and submission of a specimen for anaerobic bacteriological investigation are of paramount importance. The swab is a relatively inefficient sampling device and is often abused. A transport system may help, but a full evaluation of our sampling and transport methodology is needed and this will be influenced by local circumstances.

Anaerobiosis↗

PubMed1980

Prompt and reliable culture of exacting anaerobic bacteria in anaerobic jars.

The presently recognized anaerobic bacteria of clinical interest, with the possible exception of some spirochaetes, can be cultured by conventional procedures with an anaerobic jar. Care and attention to detail in the design and operation of an anaerobic jar are essential. Anaerobic cabinets and oxygen-free gassing systems may contribute to further research and development, but the potential usefulness of a good anaerobic jar in clinical bacteriology should not be under-rated.

Anaerobiosis↗

PubMed1980

A scheme for the identification of clinical isolates of Gram-negative anaerobic bacilli by conventional bacteriological tests.

More than 1000 strains of gram-negative anaerobic bacilli, including reference strains, clinical isolates, and members of the normal flora of the mouth, lower gastro-intestinal tract and vagina of healthy human subjects, were studied by conventional bacteriological methods and by gas-liquid chromatographic analysis of metabolic products in a series of investigations. A short combined set of tests with particular discriminant value was selected, and a scheme for the identification of the species and subspecies encountered in the diagnostic bacteriological laboratory was based upon our composite results. The tests are: antibiotic-disk resistance tests with neomycin 1000 micrograms, kanamycin 1000 micrograms, penicillin 2 units and rifampicin 15 micrograms per disk; tolerance tests with sodium taurocholate, Victoria blue 4R and gentian violet; and tests for pigment production, indole production, aesculin hydrolysis and the fermentation of glucose, lactose, sucrose, rhamnose, trehalose, mannitol and xylose. Gram-negative anaerobic bacilli are divided into four groups: (1) the fragilis group with nine species, which include the five subgroups previously classified as subspecies of B. fragilis; (2) the melaninogenicus-oralis group, which includes the three saccharolytic subspecies (ss.) of B. melaninogenicus--ss. melaninogenicus, ss. intermedius and ss. levii--and four non-pigmented species; (3) the asaccharolytic group, which comprises B. asaccharolyticus (formerly B. melaninogenicus ss. asaccharolyticus), B. corrodens and other non-pigmented non-saccharolytic strains, and (4) the fusobacteria.

Anti-Bacterial Agents↗