Bacteriology of Anaerobic Pleuropulmonary Infections: Preliminary Report

Marina, M.; Strong, C. A.; Civen, Rachel; Molitoris, E; Finegold, Sydney M.

doi:10.1093/clinids/16.supplement_4.s256

Cited by 64 publications

(28 citation statements)

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“…(9) In primary lung abscess, the secretions coming from the diseased mouth (generally with dental disease), which are aspirated during an episode of unconsciousness, contain a large quantity of several species of microorganisms (mixed flora, with a predominance of anaerobic bacteria). (10) The aspirates typically migrate to the posterior segments of the upper lobes and in the superior segments of the lower lobes, (11) and the abscesses are typically singular, appearing in the chest X-rays as cavities with irregular walls, with air-fluid levels and generally with no foci of bronchial dissemination to other sites within the lung.…”

Section: Introductionmentioning

confidence: 99%

“…Within 24 to 48 hours after the aspiration episode, the abscess will already be well formed, presenting (internally) low pH and low oxidation reduction potential, (10) which favors the multiplication of anaerobic bacteria, either grampositive (Peptostreptococcus sp, microaerophilic streptococcus) or gram-negative (Prevotella sp, Bacteroides fragilis and fusobacteria). It must be emphasized, however, that B. fragilis -a penicillinresistant bacterium -is rarely present in anaerobic infections located above the diaphragm, (12) albeit frequently found in diaphragmatic structures.…”

Section: Introductionmentioning

confidence: 99%

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Abscesso pulmonar de aspiração: análise de 252 casos consecutivos estudados de 1968 a 2004

et al. 2006

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Objective: To relate the experience of the staff at a health care facility specializing in the management of patients with aspiration lung abscess. Methods: Diagnostic aspects and therapeutic results of 252 consecutive cases of lung abscess seen in patients hospitalized between 1968 and 2004. Results: Of the 252 patients, 209 were male, and 43 were female.The mean age was 41.4 years, and 70.2% were alcoholic. Cough, expectoration, fever and overall poor health were seen over 97% of patients. Chest pain was reported by 64%, 30.2% presented digital clubbing, 82.5% had dental disease, 78.6% reported having lost consciousness at least once, and 67.5% presented foul smelling sputum. In 85.3% of the patients, the lung lesions were located either in the posterior segments of the upper lobe or in the superior segments of the lower lobe, and 96.8% were unilateral. Concomitant pleural empyema was seen in 24 (9.5%) of the patients. Mixed flora was identified in the bronchopulmonary or pleural secretions of 182 patients (72.2%). All patients were initially treated with antibiotics (mainly penicillin or clindamycin), and postural drainage was performed in 98.4% of cases. Surgical procedures were performed in 52 (20.6%) of the patients (drainage of empyema in 24, pulmonary resection in 22 and drainage of the abscess in 6). Cure was obtained in 242 patients (96.0%), and 10 (4.0%) died. Conclusion: Lung abscess occurred predominantly in male adults presenting dental disease and having a history of loss of consciousness (especially as a result of alcohol abuse). Most of the patients were treated clinically with antibiotics and postural drainage, although some surgical procedure was required in one-fifth of the study sample.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Abscesso pulmonar de aspiração: análise de 252 casos consecutivos estudados de 1968 a 2004

et al. 2006

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“…Anaerobic bacteria are common pathogens in a variety of pleuropulmonary infections, including aspiration pneumonia, lung abscesses, and empyema (1,3,6,15). However, many laboratories do not culture for anaerobes (9), diminishing awareness of the role of anaerobes in these infections.…”

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confidence: 99%

In Vitro Activity of Ceftaroline against 623 Diverse Strains of Anaerobic Bacteria

Citron¹,

Tyrrell²,

Merriam³

et al. 2010

Antimicrob Agents Chemother

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The in vitro activities of ceftaroline, a novel, parenteral, broad-spectrum cephalosporin, and four comparator antimicrobials were determined against anaerobic bacteria. Against Gram-positive strains, the activity of ceftaroline was similar to that of amoxicillin-clavulanate and four to eight times greater than that of ceftriaxone. Against Gram-negative organisms, ceftaroline showed good activity against ␤-lactamase-negative strains but not against the members of the Bacteroides fragilis group. Ceftaroline showed potent activity against a broad spectrum of anaerobes encountered in respiratory, skin, and soft tissue infections.With the continuing emergence of novel patterns of resistance to commonly used antimicrobial agents, alternative therapies are needed to treat serious infections. Ceftaroline is a novel, parenteral, broad-spectrum cephalosporin that exhibits bactericidal activity against Gram-positive organisms, such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-intermediate S. aureus, and multidrug-resistant Streptococcus pneumoniae (MDRSP) strains, as well as common Gramnegative pathogens (8,12,14,16,(18)(19)(20)(21)(22). Ceftaroline is currently in development for the treatment of complicated skin and skin structure infections and community-acquired pneumonia.Anaerobic bacteria are common pathogens in a variety of pleuropulmonary infections, including aspiration pneumonia, lung abscesses, and empyema (1, 3, 6, 15). However, many laboratories do not culture for anaerobes (9), diminishing awareness of the role of anaerobes in these infections. The main anaerobic pathogens isolated from these infections include Prevotella melaninogenica (ϳ25%), Prevotella intermedia (ϳ30%), Fusobacterium species (ϳ39%), Gram-positive cocci (ϳ30%), and Veillonella species (ϳ35%) (7). Cephalosporins such as cefoxitin have been used for the therapy of aspiration pneumonias. Although cefoxitin is active against most respiratory anaerobes, it has poor activity against the newer resistant strains of members of the family Enterobacteriaceae and MRSA. The activity of ceftaroline against Gram-positive anaerobes is similar to that of amoxicillin-clavulanate, and non-␤-lactamase-producing Gram-negative strains generally have low ceftaroline MICs (present study), suggesting that ceftaroline might have an adequate spectrum of activity for therapy for some cases of aspiration pneumonia.To investigate the broader potential of ceftaroline, we compared its in vitro activity against 623 unique clinical isolates of anaerobic bacteria representing 5 Gram-negative bacterial genera and 17 Gram-positive bacterial genera to the activities of ceftriaxone, metronidazole, clindamycin, and amoxicillinclavulanate.The reference agar dilution procedure described in CLSI document M11-A7 was used (5). The organisms were recovered from a variety of clinical specimens and were stored at Ϫ70°C in 20% skim milk. Identification was accomplished by standard phenotypic methods or by partial 16S rRNA gene sequencing for strains that could not b...

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“…In studies of several hundred patients with anaerobic infection of the lung and pleural space performed between 1968 and 1991, the predominant anaerobic strains were consistently Peptostreptococcus, Bacteroides species, and Fusobacterium nucleatum [27,[32][33][34]. Bacteroides fragilis deserves special mention because it was once reported to occur in 15% to 20% of anaerobic pulmonary infections.…”

Section: Microbiologymentioning

confidence: 99%

Anaerobic infections of the lung

Chung

Goetz

2000

Curr Infect Dis Rep

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Although the landmark investigational period for anaerobic pathogens occurred more than 20 years ago, pleuropulmonary infections caused by these pathogens remain an important cause of morbidity and mortality. Despite heightened awareness of pathogenicity and new diagnostic methods, the actual incidence of anaerobes in pulmonary infections--especially those occurring in hospitalized patients--remains controversial. Further complicating the management of these infections is the changing antimicrobial susceptibility of oral anaerobes, which has mandated the abandonment of penicillin monotherapy in seriously ill patients. This article reviews the pathogenesis of anaerobic pulmonary infections, their clinical presentations, and current management issues.

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Bacteriology of Anaerobic Pleuropulmonary Infections: Preliminary Report

Cited by 64 publications

References 7 publications

Abscesso pulmonar de aspiração: análise de 252 casos consecutivos estudados de 1968 a 2004

Abscesso pulmonar de aspiração: análise de 252 casos consecutivos estudados de 1968 a 2004

In Vitro Activity of Ceftaroline against 623 Diverse Strains of Anaerobic Bacteria

Anaerobic infections of the lung

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