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PubMed2001

Influence of in-vivo endotoxin liberation on anti-anaerobic antimicrobial efficacy.

The ability of cefoxitin, clindamycin, imipenem, meropenem, metronidazole and piperacillin-tazobactam to cause gram-negative anaerobic bacteria to release endotoxin and the influence of such liberated endotoxin on antibiotic efficacy were investigated in in-vivo experiments in animal models. Experimental infections in various animal models (mice, hamster and infant rats) with cultures of wild and reference strains of Bacteroides fragilis group and Fusobacterium spp. were carried out by injecting these animals with different inocula (10(6), 10(7) and 10(8) cfu/ml) of the bacterial suspension, Appropriate doses of the test antibiotics were then injected and the plasma lipopolysaccharide (endotoxin) release measured by the Limulus Amoebocyte Lysate (LAL) Assay. Evidence of worsening of the outcome of the infections post-therapy was assessed, including histopathological changes in the internal organs. Infection with generalized septicemia was established with F. nucleatum in the mice and hamster models while with the B. fragilis group, infections only led to intra-abdominal abscess formation. Plasma endotoxin release was higher in animals infected with F. nucleatum than B. fragilis and was unrelated to the bacterial inoculum. Imipenem, meropenem and cefoxitin, in that order, induced the highest levels of endotoxin activities in the animal model, particularly following F. nucleatum infection. Histological examination of the internal organs of various animals showed variation in the pattern of histopathological changes; grades 3-4 inflammatory changes in the liver were observed in the Fusobacterium-infected animals that were treated with the carbapenems and cefoxitin. Therapy with the other antibiotics did not exacerbate anaerobic sepsis. In this study, bacteremia did not lead to massive endotoxin release and antibiotic therapy appeared not to have negatively influenced the outcome of most of the gram-negative anaerobic infections, except for infections caused by Fusobacterium spp. However, it is conceivable that if the gastrointestinal tract is the source of the endotoxin in patients with systemic inflammatory response syndrome, then the obligate anaerobes like Bacteroides and Fusobacterium species, which are members of the gut flora, may play a major role in the unfavorable outcome of antibiotic therapy in some of these infections.

Animals↗

PubMed1989

Ischaemic mouse thigh model for evaluation of pathogenicity of non-clostridial anaerobes.

A mouse thigh model has been devised in which the growing culture of non-clostridial anaerobe in the ischaemic tissue produces inflammatory swelling and death. The swelling of the right thigh served as an index of pathogenicity of the test strain in comparison to the negatively reacting left thigh which received injection of the control strain of Bifidobacterium infantis. Actinomyces naeslundii exceptionally caused death in all animals within 24 h. Mortality and thigh swelling were pronounced (greater than 75%) in case of Fusobacterium gonidiaformans and Propionibacterium acnes but less (less than 50%) in Acidaminococcus fermentans. High (less than 75%) rate of thigh swelling was also encountered in case of Bacteroides oralis, Bacteroides corrodens, Fusobacterium necrophorum, Fusobacterium prausnitzii, Fusobacterium plauti, Peptococcus prevotii, Streptococcus intermedius, Eubacterium lentum and Propionibacterium freudenreichii ss. shermanii.

Animals↗

PubMed1993

[The role anaerobes in dermatitis digitalis et interdigitalis in cattle].

Altogether 52 tissue samples and swabs from the corium of the claw of diseased cattle were investigated. Microbiological examinations revealed the presence of 11 strictly anaerobic bacterial strains that belonged to the species Peptococcus asacharolyticus, Pc. sacharolyticus, Peptostreptococcus anaerobius, Bacteroides asacharolyticus and B. melaninogenicus. The remaining isolates were classified as Bacteroides, Fusobacterium, Streptococcus and Clostridium. In the above-mentioned strains observations of their biochemical, morphological and enzymatic properties (Tab. I) were carried out. Their resistance to antibiotics was evaluated from the qualitative viewpoint (Tab. II). Capillary isotachophoresis was used to determine the amounts of volatile fatty acids that developed during glucose fermentation (Tab. III). In the single clinical samples the above-mentioned strains occurred as association of microorganism. The anaerobic genera Bacteroides and Fusobacterium were found in 52% of the samples (Bacteroides sp. and Fusobacterium sp. were recorded in 25% and 12% of the samples, respectively, whereas in 15% of the samples both species occurred). According to our results the etiology of dermatitis digitalis et interdigitalis is closely connected with the incidence of anaerobes. Of the latter, those belonging to the genera Bacteroides and Fusobacterium are of major importance.

Animals↗

PubMed1976

Hyperbaric oxygen exposures for intrahepatic abscesses produced in mice by nonsporeforming anaerobic bacteria.

Hyperbaric oxygen exposures were evaluated for treatment of progressive liver abscesses produced by intraperitoneal injection of combined cultures of Fusobacterium necrophorum plus either Bacteroides fragilis subsp. fragilis or Fusobacterium nucleatum in a mouse model. Infected control and hyperbaric oxygen-exposed mice were autopsied 5 or 6 weeks after inoculation of bacteria and were assigned numerical pathology scores according to the number and size of abscesses present. Seventeen daily 3-h exposures to 100% O(2) at 2 atmospheres absolute pressure begun either 1 day or 1 week after injection of bacteria significantly reduced the number and size of abscesses among mice infected with either mixture of anaerobic organisms. Abscesses due to mixed fusobacteria were often completely resolved. These data support the efficacy of hyperbaric oxygen for treatment of mixed anaerobic infection produced by Bacteroides and Fusobacterium species and suggest its further evaluation as a potential alternate or adjunct to present therapy for certain types of serious anaerobic infection.

Animals↗

PubMed1998

Subgingival microflora associated with nifedipine-induced gingival overgrowth.

The purpose of this study was to examine the composition of subgingival plaque of 140 periodontal lesions in 35 patients with cardiovascular disorders who were administered nifedipine and manifested nifedipine-induced gingival overgrowth (GO). Age was inversely associated with the GO. Plaque index and bleeding index showed a significant association with GO, while nifedipine dosage and duration of nifedipine therapy were not found to be significant predictors of GO. The gingival inflammation as expressed in the logistic regression model by the interaction term color x tone was found to be significantly associated with the GO. Statistically significant differences between the groups of comparable probing depth and different degrees of GO were detected for Propionibacterium acnes, Capnocytophaga gingivalis, Capnocytophaga ochracea, Capnocytophaga sputigena, Bacteroides gracilis, Fusobacterium mortiferum, Fusobacterium nucleatum, Fusobacterium varium and Selenomonas sputigena in deep and enlarged lesions. Significantly more frequently isolated were the bacterial species Eubacterium alactolyticum, Campylobacter concisus, C. gingivalis, C. ochracea, C. sputigena, F. mortiferum, F. nucleatum, and F. varium from the more enlarged lesions (GO >3).

Adult↗

PubMed1993

[Diagnostic imaging in Lemierre's+ syndrome].

BACKGROUND: The Lemierre syndrome is a septic picture with jugular thrombophlebitis and secondary septic embolisms usually produced by Fusobacterium necrophorum. In previous reports published in the literature, imaging techniques are seldom referred to report the presence of jugular thrombophlebitis. A case of the Lemierre syndrome is presented with the aim of calling attention to this process and its current diagnostic possibilities. METHODS: The case of a patient who was diagnosed of having a Lemierre syndrome with sepsis by Fusobacterium is presented, with radiologic pulmonary embolisms. The echo-Doppler exam showed the presence of internal jugular involvement in absence of signs and symptoms leading to suspicion. A review of 6 cases is also made with special attention being given to the data on jugular vein involvement. RESULTS: Only in 2 of the 6 patients reviewed were imaging techniques used on the internal jugular view (in one 2D echography and in the other computerized axial tomography) with the diagnosis being performed on the base of symptomatic and physical exam data in the remaining 4 cases. CONCLUSIONS: The Lemierre syndrome should be suspect in all patients with bacteremia by Fusobacterium and radiologic imaging of pulmonary embolism, even in the absence of signs and symptoms of oropharyngeal and jugular involvement. Modern imaging techniques, particularly echo-Doppler, may play an important diagnostic role.

Adult↗

PubMed2005

Fusobacteriosis presenting as community acquired pneumonia.

Fusobacterium species are anaerobic Gram-negative bacilli, which colonise the mucus membranes of man and animals and can cause a number of clinical manifestations including Lemierre's disease (postanginal septicaemia), abdominal infection and deep-seated abscesses. The incidence of fusobacterium infections appears to be increasing, and we present three cases of fusobacteriosis who presented with features of community acquired pneumonia (CAP). Cases were treated with benzyl penicillin and metronidazole, co-amoxiclav and metronidazole and amoxicillin and clarithromycin. Since some of the Fusobacterium species are resistant to penicillin and erythromycin, treatment with these antibiotics in cases of fusobacteriosis presenting as CAP may lead to treatment failure. A high index of clinical suspicion is required to recognise this rare cause of CAP.

Adult↗

PubMed1982

Composition of peptidoglycans in Bacteroidaceae: determination and distribution of lanthionine.

Peptidoglycans of organisms belonging to the strictly anaerobic family Bacteroidaceae were investigated for the presence of lanthionine. Different procedures for the quantitation of lanthionine were compared. Performic acid and peroxide oxidation procedures on 35S-labeled peptidoglycan from Fusobacterium nucleatum Fev1 resulted in low yields of cysteic acid (42 and 60%, respectively) and many other additional unidentified oxidation products. Lanthionine was, however, recovered in high yield (89% or more) from acid hydrolysates of unoxidized peptidoglycans. Lanthionine was found exclusively in some species of Fusobacterium, in particular F. nucleatum, F. necrophorum, F. russi, and F. gonidiaformans, for which lanthionine may be ascribed a function as a taxonomic marker. Peptidoglycans of these bacteria are thus proposed to belong to a new chemotype, assigned A1 delta. One strain of Fusobacterium, F. mortiferum VPI 0473 contained both lanthionine and diaminopimelic acid in about equal proportions. Species of F.plauti had a composition atypic of gram-negative cells. Chemotypic differences were also indicated among the species of Bacteroides investigated. Thus, some species contained lysine and not diaminopimelic acid as the major dibasic amino acid (e.g., F. asaccharolyticus). It is concluded that peptidoglycans of gram-negative organisms constitute a somewhat more heterogeneous group than hitherto assumed.

Alanine↗

PubMed1986

DNA probes for identification of clinically important Bacteroides species.

Conventional procedures for identifying gram-negative anaerobes such as Bacteroides spp. are cumbersome and time-consuming. A simpler approach would be to use DNA probes to identify these organisms. Since many different species of gram-negative anaerobes are isolated from clinical specimens, the most useful DNA probes would be probes that identify a few clinically significant groups of anaerobes. To obtain such probes, we cloned HindIII-digested chromosomal DNA from various Bacteroides species and then screened these probes, labeled with 32P by nick translation, for hybridization to DNA from various species of Bacteroides, Fusobacterium, and other gram-negative bacteria. We identified three DNA probes (pBFII-4, pBFII-5, and pBFII-6) that hybridized specifically to DNA from Bacteroides fragilis, the species that accounts for about half of all isolates from clinical specimens containing anaerobes. We identified one DNA probe (pBE-3) that hybridized to all members of the B. fragilis group, a group of species that resemble B. fragilis with respect to fermentation pattern and antibiotic resistances. We also identified one probe (pBO-21) that hybridized to DNA from all Bacteroides sp. strains as well as to DNA from strains of Fusobacterium necrophorum and Fusobacterium nucleatum. pBO-21, but not pBE-3, cross-hybridized with a cloned Bacteroides sp. 16S rRNA gene. The limit of detection for these probes was 10(6) bacteria. The probes could detect B. fragilis in blood culture medium and in mixed cultures with other gram-negative bacteria. Attempts to use biotin-labeled DNA probes instead of 32P-labeled probes were not successful because the Bacteroides sp. extracts contained material that bound the streptoavidin-peroxidase detection reagent.

Animals↗

PubMed1988

Recovery of anaerobic bacteria from clinical specimens in 12 years at two military hospitals.

Examination of 15,844 clinical specimens submitted over 12 years (1973 to 1985) to the anaerobic microbiology laboratories in two military hospitals demonstrated the recovery of anaerobic bacteria in 4,458 (28.1%) specimens. The specimens yielded 6,557 anaerobic isolates (1.47 isolates per specimen). Bacteroides spp. accounted for 43% of all isolates; anaerobic gram-positive cocci, 26%; Clostridium spp., 7%; and Fusobacterium spp., 4%. Bacteroides spp. predominated in abscesses, obstetrical and gynecological (OBG) infections, abdominal infections, cysts, wounds, and tumors. Members of the Bacteroides fragilis group accounted for 44% of all Bacteroides spp., and of them, B. fragilis was mostly isolated in abscesses, wounds, abdomen, and blood. Pigmented Bacteroides spp. accounted for 21% of all Bacteroides sp. isolates and were mostly isolated in sinus, eye, chest, bone, and ear infections. Bacteroides melaninogenicus accounted for 42% of this group's isolates. Bacteroides bivius accounted for 9% of Bacteroides spp., and most isolates were found in OBG infections. Anaerobic gram-positive cocci were mostly isolated in OBG infections, abscesses, and wounds. The predominant anaerobic gram-positive cocci were Peptostreptococcus magnus (18%), Peptostreptococcus asaccharolyticus (17%), Peptostreptococcus anaerobius (16%), and Peptostreptococcus prevotii (13%). Clostridium spp. were mostly isolated from wounds, abscesses, abdominal infections, and blood. The predominant strain was Clostridium perfringens (48%). Fusobacterium spp. were recovered in abscesses and abdominal and OBG infections. The predominant isolate was Fusobacterium nucleatum (47%). These data illustrate the relative frequency of the different anaerobic bacteria in a variety of infections and demonstrate the predominance of certain isolates at different sites.

Bacteria, Anaerobic↗

PubMed2003

Fusobacterial brain abscess: a review of five cases and an analysis of possible pathogenesis.

OBJECT: The cases of five patients with fusobacterial brain abscess are presented. The authors discuss their attempt to determine the pathogenesis. METHODS: The clinical and microbiological features of five cases of fusobacterial brain abscess are reviewed. Isolates of 2031 Fusobacterium spp. and other anaerobes collected (1989-2002) at our institution were analyzed and compared for incidences and isolation sources. The findings were correlated with extensive literature on the subject. The five patients were men between 45 and 74 years of age. All experienced an insidious onset of the disease and probable hematogenous seeding of the organism(s). One patient had a monomicrobic Fusobacterium necrophorum abscess, whereas the others had polymicrobic F. nucleatum abscesses. Despite surgery and a regimen of antibiotic medications and dexamethasone, three patients experienced a paradoxical deterioration 3 days postoperatively that necessitated reevacuation of the lesion. The evacuants observed at that time contained numerous leukocytes but no microorganisms, suggesting intensified inflammation as the likely cause of deterioration. This explanation is supported by literature that fusobacteria strongly activate neutrophils. An analysis of the 2031 anaerobes from blood, wounds, and abscesses showed the considerable virulence of Fusobacterium spp., which were able to enter and/or sustain themselves in the blood circulation. This pattern was similar to that of Clostridium spp., but different from those of Peptostreptococcus spp., Bacteroides spp., and Prevotella spp., which were less invasive but more abundant. CONCLUSIONS: Some fusobacterial brain abscesses may be associated with a paradoxical postoperative deterioration, which is probably due to intensified inflammation following treatment. The blood-borne dissemination and invasive behavior of fusobacteria likely initiate such a brain abscess, and further seeding of other synergic bacteria leads to a polymicrobic abscess.

Aged↗

PubMed2000

Comparison of microbial composition in the subgingival plaque of adult crowded versus non-crowded dental regions.

It has been reported in the literature that certain species of bacteria (periodontopathogens) present in the subgingival plaque are associated with destructive periodontal disease. The purpose of this study was to investigate and compare the presence and proportional distribution of periodontopathogens in the subgingival plaque of adult crowded versus non-crowded dental regions. Thirty adult patients with anterior dental crowding were selected from the Orthodontic Clinic of the University of Pennsylvania. After orthodontic records were taken and the periodontal examination was performed, subgingival plaque samples were collected from crowded (experimental) and contralateral non-crowded regions (control) of each patient. The presence of 9 periodontopathic species, Actinobacillus actinomycetemcomitans, Prevotella intermedia, Eikenella corrodens, Campylobacter rectus, Capnocytophaga species, Fusobacterium species, Peptostreptococcus micros, Porphyromonas gingivalis, and Bacteroides forsythus, was determined using culture and immunofluorescence techniques. The bacterial morphotype was also determined by the use of dark-field microscopy. It was found that supragingival plaque accumulation in crowded regions was significantly greater than in non-crowded regions. Analysis of the bacteria showed that the samples from crowded regions consistently contained more species of periodontopathogens than the samples from non-crowded regions. Morphologically, more spirochetes and motile rods were present in the crowded-region samples. In terms of the presence of individual periodontopathogens, Fusobacterium species, Capnocytophaga species, C rectus, and P micros were significantly more common in the crowded samples than in the non-crowded samples. It was concluded that: (1) more plaque accumulated in crowded areas; (2) more species of periodontopathogens were present in the subgingival plaque of crowded regions; (3) morphologically, more spirochetes and motile rods were present in crowded areas; and (4) Fusobacterium species, Capnocytophaga species, C rectus, and P micros were present more often in crowded areas than in non-crowded areas (P < 0.05).

Adolescent↗

PubMed1977

[In vitro susceptibility of bacteroidaceae to cefoxitin and cephalothin (author's transl)].

The activity of the new cephamycin C derivatives cefoxitin against 102 clinical isolates of Bacteroidaceae (95 Bacteroides strains and 7 Fusobacterium-Sphaerophorus cultures) was determined by tube dilution and standardized agar diffusion tests and compared to that of cephalothin. Cefoxitin was more active than cephalothin against 56 Bacteroides fragilis strains, 19 Bacteroides thetaiota-omicron strains and two Bacteroides splanchnicus strains. The difference seemed less pronounced with five Bacteroides vulgatus and four Bacteroides variabilis cultures. Three Bacteroides melaninogenicus and six Bacteroides oralis strains displayed similar sensitivity to both cephalosporins. At concentrations of 32 microng/ml or less, cefoxitin inhibited 91% and cephalothin 33% of the Bacteroides strains. Two strains of Sphaerophorus varius were likewise much more sensitive to cefoxitin than to cephalothin (MIC values 8 micron8/ml of cefoxitin and 256 microng/ml of cephalothin). Three other Sphaerophorus strains (the species necrophorus and freundii/mortiferum) and two of Fusobacterium fusiforme (Fusobacterium nucleatum) strains were very similar in their susceptibility to both cephalosporins. Statistical analysis of the relationship between MIC and zone size diameter showed relatively high correlation coefficients for cefoxitin and cephalothin (r=-0.741 and r=-0.703 respectively).

Bacteroidaceae↗

PubMedDate not supplied

Comparative in vitro activity of cefpodoxime against anaerobes other than Bacteroides fragilis.

To assess the in vitro activity of cefpodoxime against anaerobic respiratory tract and oropharyngeal pathogens 77 strains belonging to 18 gram-negative and 7 gram-positive species were studied by means of agar dilution tests. For comparison cefuroxime, amoxicillin, amoxicillin + clavulanic acid and clindamycin were also tested. Cefpodoxime was found to be active at concentrations of less than or equal to 0.125 mg/l against Prevotella oralis, Prevotella buccalis, Prevotella bivia, Porphyromonas asaccharolytica, Bacteroides corporis, Bacteroides gracilis, Fusobacterium necrophorum, Fusobacterium naviforme and Propionibacterium acnes. Prevotella oris, Prevotella buccae, Fusobacterium nucleatum, Peptostreptococcus asaccharolyticus, and Ruminococcus bromii were inhibited at concentrations of less than or equal to 1 mg/l and Prevotella denticola, Prevotella melaninogenica, Prevotella intermedia, Porphyromonas gingivalis, Bacteroides pneumosintes, and Peptostreptococcus micros at concentrations of less than or equal to 4 mg/l. Strains of Veillonella parvula were inhibited by cefpodoxime at 0.25-8 mg/l, and single strains of Peptostreptococcus anaerobius and Peptostreptococcus magnus showed MICs of 32 and 64 mg/l, respectively. The results obtained warrant the use of cefpodoxime in therapy of anaerobic and mixed aerobic-anaerobic infections of the upper and lower respiratory tract and similar infections not involving Bacteroides fragilis.

Anti-Bacterial Agents↗

PubMed2005

Coaggregation profiles of the microflora from root surface caries lesions.

Bacterial coaggregation reactions between different species and the auto aggregation of the same species are associated with the initiation and development of dental plaque and biofilms. As no such data is available on isolates from root caries lesions, we evaluated, by a visual, semi-quantitative scoring system and a spectrophotometric, quantitative assay, the coaggregation of 22 different wild-type microbial species comprising ten bacterial genera and a single Candida spp. The quantitative coaggregation assay we used proved to be a more sensitive method than the semi-quantitative, visual evaluation as the results yielded the percent coaggregation. Fusobacterium nucleatum, Lactobacillus acidophilus, Streptococcus bovis II/2 and Gemella morbillorum were observed having higher degrees of autoaggregation than the other examined strains. Significant levels of inter-species coaggregation was seen between: (1) Actinomyces spp. and Veillonella spp.; (2) Actinomyces israelii and Peptostreptococcus prevotii; (3) Campylobacter gracilis and Actinomyces spp.; (4) Prevotella intermedia and nine different species; and (5) Fusobacterium nucleatum and six other species. The single Candida albicans isolate did not coaggregate to a significant extent with any of the 21 bacterial isolates studied. Scanning electron microscopy observation of the coaggregation interactions between bacterial pairs having strong coaggregation reactions revealed varying adhesive patterns. Our findings on coaggregation amongst these isolates imply existence of multiple interactions between the coaggregation-inducing bacterial species in root caries. In particular, Actinomyces spp., Veillonella spp., Prevotella spp. and Fusobacterium spp. appear to play a significant role in this context.

Aged↗

PubMed1998

Microbiology of liver and spleen abscesses.

To study the aerobic and anaerobic microbiology of liver and spleen abscesses and correlate the results with predisposing factors, potential causes and routes of infection, clinical and laboratory data of 48 patients with liver abscesses and 29 with spleen abscesses treated between 1970 and 1990 were reviewed retrospectively. In liver abscesses, a total of 116 isolates (2.4 isolates/specimen) was obtained; 43 were aerobic and facultative species (0.9 isolates/specimen) and 73 were anaerobic species or microaerophilic streptococci (1.5 isolates/specimen). Aerobic bacteria only were isolated from 12 (25%) abscesses, anaerobic bacteria only from eight (17%), and mixed aerobic and anaerobic bacteria from 28 (58%); polymicrobial infection was present in 38 (79%). The predominant aerobic and facultative isolates were Escherichia coli (11 isolates), Streptococcus group D (8), Klebsiella pneumoniae (5) and Staphylococcus aureus (4). The predominant anaerobes were Peptostreptococcus spp. (18 isolates), Bacteroides spp. (13), Fusobacterium spp. (10), Clostridium spp. (10) and Prevotella spp. (4). There were 12 isolates of micro-aerophilic streptococci. S. aureus and beta-haemolytic streptococci were associated with trauma; Streptococcus group D, K. pneumoniae and Clostridium spp. with biliary disease; and Bacteroides spp. and Clostridium spp. with colonic disease. In splenic abscesses, a total of 56 isolates (1.9 isolates/specimen) was obtained; 23 were aerobic and facultative species (0.8 isolates/specimen), 31 were anaerobic species or micro-aerophilic streptococci (1.1 isolates/specimen) and two were Candida albicans. Aerobic bacteria only were isolated from nine (31%) abscesses, anaerobic bacteria from eight (28%), mixed aerobic and anaerobic bacteria from 10 (34%) and C. albicans in two (7%); polymicrobial infection was present in 16 (55%). The predominant aerobic and facultative isolates were E. coli (5 isolates), Proteus mirabilis (3), Streptococcus group D (3), K. pneumoniae (3) and S. aureus (4). The predominant anaerobes were Peptostreptococcus spp. (11 isolates), Bacteroides spp. (5), Fusobacterium spp. (3) and Clostridium spp. (3). S. aureus, K. pneumoniae and Streptococcus group D were associated with endocarditis, E. coli with urinary tract and abdominal infection, Bacteroides spp. and Clostridium spp. with abdominal infection and Fusobacterium spp. with respiratory infection.

Abscess↗

PubMed2006

Anaerobic bacteria in 118 patients with deep-space head and neck infections from the University Hospital of Maxillofacial Surgery, Sofia, Bulgaria.

The aim of this study was to assess the incidence and susceptibility to antibacterial agents of anaerobic strains in 118 patients with head and neck abscesses (31) and cellulitis (87). Odontogenic infection was the most common identified source, occurring in 73 (77.7%) of 94 patients. The incidence of anaerobes in abscesses and cellulitis was 71 and 75.9%, respectively, and that in patients before (31 patients) and after (87) the start of empirical treatment was 80.6 and 72.4%, respectively. The detection rates of anaerobes in patients with odontogenic and other sources of infection were 82.2 and 71.4%, respectively. In total, 174 anaerobic strains were found. The predominant bacteria were Prevotella (49 strains), Fusobacterium species (22), Actinomyces spp. (21), anaerobic cocci (20) and Eubacterium spp. (18). Bacteroides fragilis strains were isolated from 7 (5.9%) specimens. The detection rate of Fusobacterium strains from non-treated patients (32.2%) was higher than that from treated patients (13.8%). Resistance rates to clindamycin and metronidazole of Gram-negative anaerobes were 5.4 and 2.5%, respectively, and those of Gram-positive species were 4.5 and 58.3%, respectively. One Prevotella strain was intermediately susceptible to ampicillin/sulbactam. In conclusion, the start of empirical treatment could influence the frequency or rate of isolation of Fusobacterium species. The involvement of the Bacteroides fragilis group in some head and neck infections should be considered.

Abscess↗

PubMed1998

Subgingival microbiota of shallow periodontal pockets in individuals after head and neck irradiation.

This study aimed at investigating the subgingival plaque microorganisms of shallow pockets (< or = 5 mm) in subjects who previously received irradiation in the head and neck region for treatment of nasopharyngeal carcinoma. Direct microscopy and anaerobic culture were used. Subgingival paper point samples were taken from 6 tooth-sites (one/sextant) per subject for direct microscopy (n = 108). Another set of paper points was taken from the deepest of the previously selected sites (one per subject) with: group A) no bleeding on probing to the sulcus depth (n = 9) and group B) bleeding on probing to the sulcus depth (n = 6) for microscopic and anaerobic culture study. Under the microscope, the microflora was found to be a complex mixture comprising gram-positive and gram-negative cocci, rods and filaments, fusiforms, curved rods and spirochetes. Low level of fungi were observed and mycelia were occasionally detected. There was no significant variation in the plaque bacterial morphotypes observable according to sites of isolation and no significant difference between group A and group B in morphotypes of the different microflora. The predominant cultivable microflora comprised several species of facultative and obligate anaerobic bacteria: Gemella, Peptostreptococcus, Staphylococcus, Stomatococcus, Streptococcus, Actinomyces, Eubacterium, Lactobacillus, Propionibacterium, Neisseria, Veillonella, Bacteroides, Campylobacter, Capnocytophaga, Fusobacterium, Kingella, Porphyromonas and Prevotella species. There was no difference between the two groups except the significantly higher proportion of Kingella dentrificans isolated from group B sites. However, colonization of the gingival sulcus in these individuals by microbes that are normal flora of: skin (Peptostreptococcus prevotii and Propionibacterium granulosum) and gut (Eubacterium aerofaciens, Fusobacterium mortiferum and Fusobacterium varium) was detected. These findings appear to suggest that the major components of the subgingival microflora of shallow sites in previously head- and neck-irradiated individuals are similar to that of gingivitis sites in the normal population although they may contain bacterial or fungal species uncommon in normal subjects.

Adult↗