Case series of Anaerococcus prevotii infection in road traffic accidents in New Delhi, India

Abstract

Anaerobic bacteria are part of the normal human skin flora. However, anaerobic infections could have different clinical courses with outcomes ranging from local abscesses to life-threatening conditions. Any long-term wound infection or a wound discharging pus with a foul smell is an indication of anaerobic infections. We present here a series of three cases of infection in patients injured in road traffic accidents (RTA) in which Anaerococcus prevotii was identified as the pathogen. Samples isolated from tissues of patients from three different RTAs were received in anaerobic conditions in Robertson Cooked Meat medium (RCM) within 2-4 h of collection. RCM was incubated for 24 h and then inoculated on three blood agars (BA) plates cultured anaerobically in a Gas Pack Jar, in a CO2 incubator, or aerobically. No growth was noted on the aerobically incubated plate. After 48 h, anaerobic plates were examined for growth and a Gram stain was performed. The identity of isolated colonies was confirmed by VITEK-2, and sensitivity testing was done by the pour plate method using Epsilon meter strips. All three tissue samples isolated from (1) the right leg, (2) the right inguinal region, and (3) the left thigh of patients revealed Anaerococcus prevotii, and two isolates showed resistance to the antibiotic metronidazole. Any injury with long-term infection, especially in patients suffered from RTAs, needs to be scrutinized for anaerobic infections since they are common in RTA related injuries. No random medication should be administered without prior culture sensitivity testing, because it might contribute to metronidazole or other antibiotics resistance.