Aerobic and anaerobic infection associated with malignancy

Abstract

The goal of this work was to study the microbiology and clinical characteristics of patients with infections associated with malignancy treated over a period of 17 years. A total of 668 specimens were obtained from 605 patients. The malignancies include 224 hematological malignancies and 381 nonhematogenic malignancies. Anaerobic bacteria only were isolated in 201 (30%) specimens, aerobic bacteria in 226 (34%), mixed aerobic-anaerobic bacteria in 231 (35%) and Candida spp. in 10 (1%). A total of 683 anaerobic (1.0 isolates per specimens) and 592 aerobic or facultative (0.9 per specimen) organisms were recovered. The predominant anaerobic bacteria included Bacteroides fragilis group isolates (181), Peptostreptococcus spp. (166), Prevotella spp. (106), Clostridium spp. (70), and Fusobacterium spp. (43). The predominant aerobic bacteria included Escherichia coli (133), Staphylococcus aureus (100), Klebsiella pneumoniae (48), and Pseudomonas aeroginosa (45). The type of infections included abscesses (221), bacteremia (198), wounds (175), including 61 cellulitis, 24 post-surgical wounds and 23 decubitus ulcers), peritonitis (48), empyema (12), cholecystitis (6) and thrombophlebitis (5). S. aureus and Peptostreptococcus spp. were isolated from all sites. However, organisms of the oropharyngeal flora (Prevotella and Fusobacterium spp.) predominated in local infections and bacteremia that originated from this site (head and neck wounds and abscesses and pulmonary infections), and organisms of the gastrointestinal tract flora predominated in infections that originated from this site (peritonitis, abdominal abscesses and decubitus ulcers). This retrospective study demonstrates polymicrobial features of many infections associated with malignancies.

Pyogenic liver abscess in the elderly: clinical features, outcomes and prognostic factors

“…Information regarding antibiotic usage prior to admission was not obtained in this retrospective study, which may weaken this finding. Underlying malignancy, which was more prevalent in older PLA patients, has been regarded as a risk factor for developing anaerobic infections [20,21]. This may explain why anaerobic pathogens were more frequently recovered in older patients than in the young.…”

Human Necrobacillosis, with Emphasis on Lemierre's Syndrome

“…A combined antibiotic course with a b-lactam and metronidazole for 2 weeks is normally sufficient to resolve the infection, which is rarely complicated by metastatic abscesses. The main problem in these patients is their age and the frequent relation of infection to cancers, which occurs in up to 69% of patients with F. necrophorum infection from the gastrointestinal and urogenital tracts [23,24,26,30,109]. Whenever F. necrophorum bacteremia is diagnosed in this age group, thorough examination for cancer is obligatory, if it has not already been diagnosed.…”

Routine Anaerobic Blood Cultures: Back Where We Started?

“…Clostridium septicum is highly associated with malignancy [21]; Clostridium sordellii can be associated with childbirth or abortion, with up to a 100% case-fatality rate [22]; Clostridium novyi is associated with injection drug use [23]; and several Clostridium species are associated with intraabdominal or pelvic infection that might not be obvious clinically. Bacteremia due to Fusobacterium necrophorum [24] can be associated with a number of underlying diseases [24], and Peptostreptococcus species is increasingly associated with malignancy [25]. Lassmann et al [7] reported an increased trend in the isolation of Peptostreptococcus species, most often associated with malignancy, immunosuppression, and recent gastrointestinal or gynecological surgery.…”