Routine Anaerobic Blood Cultures: Back Where We Started?

Hecht, David W.

doi:10.1086/512440

Cited by 23 publications

(11 citation statements)

References 27 publications

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“…Accurate species determination for anaerobes from blood cultures has become increasingly important, because anaerobic bacteremia with multiple-drug-resistant organisms has emerged as a significant health care problem as there are more patients at risk from immunosuppression and multiple comorbidities (6)(7)(8)(9). To our knowledge, this study is the first longitudinal survey of anaerobic bacteremia at a large tertiary care hospital that identified anaerobes by 16S rRNA gene sequencing.…”

Section: Discussionmentioning

confidence: 99%

Genotypic Diversity of Anaerobic Isolates from Bloodstream Infections

et al. 2008

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Accurate species determination for anaerobes from blood culture bottles has become increasingly important with the reemergence of anaerobic bacteremia and prevalence of multiple-drug-resistant microorganisms. Our knowledge of the taxonomical diversity of anaerobes that cause bloodstream infections is extremely limited, because identification historically has relied on conventional methods. Over a 5-year period, we profiled anaerobic bacteremia at a large tertiary care hospital with 16S rRNA gene sequencing to gain a better understanding of the taxonomical diversity of the bacteria. Of 316 isolates, 16S rRNA gene sequencing and phylogenetic analysis identified 316 (100%) to the genus or taxonomical group level and 289 (91%) to the species level. Conventional methods identified 279 (88%) to the genus level and 208 (66%) to the species level; 75 (24%) were misidentified at the species level, and 33 (10%) results were inconclusive. High intragenus variability was observed for Bacteroides and Clostridium species, and high intraspecies variability was observed for Bacteroides thetaiotaomicron and Fusobacterium nucleatum. Sequence-based identification has potential benefits in comparison to conventional methods, because it more accurately characterizes anaerobes within taxonomically related clusters and thereby may enable better correlation with specific clinical syndromes and antibiotic resistance patterns.

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Section: Discussionmentioning

confidence: 99%

Genotypic Diversity of Anaerobic Isolates from Bloodstream Infections

et al. 2008

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“…However, recently anaerobic bacteremia seemed to have re-emerged as a significant clinical problem [6] leading the debate Bback where we started^ [21]. Several factors have been questioned in order to explain this trend, including the change in culture media, increased awareness of the importance of anaerobes in human infection, antibiotic policies and, underlying disease and comorbidities [6].…”

Section: Discussionmentioning

confidence: 99%

Are incidence and epidemiology of anaerobic bacteremia really changing?

Vena

Alcalá

Fernández‐Cruz

et al. 2015

Eur J Clin Microbiol Infect Dis

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Incidence, prognosis and need of performing blood cultures for anaerobic bacteria are under debate, mainly due to the belief that the presence of anaerobes in blood can be easily suspected on clinical basis. We aimed to assess these three points in a retrospective analysis of a 10-year experience in our tertiary hospital. All episodes of significant anaerobic bacteremia diagnosed from 2003 to 2012 were included. Risk factors for mortality and clinical predictability of anaerobic bacteremia were evaluated in 113 randomly selected episodes. Overall incidence of anaerobic bacteremia was 1.2 episodes/1000 admissions, with no significant changes during the 10-year study period. B. fragilis group (38.1 %) and Clostridium spp. (13.7 %) were the most frequent isolated microorganisms. As for the clinical study, 43.4 % of the patients had a comorbidity classified as ultimately fatal or rapidly fatal according to the McCabe and Jackson scale. Clinical manifestations suggestive of anaerobic involvement were present in only 55 % of the patients. Twenty-eight patients (24.8 %) died during the hospitalization. Independent predictive factors of mortality were a high Charlson's comorbidity index and presentation with septic shock, whereas, an adequate source control of the infection was associated with a better outcome. In our centre, incidence of anaerobic bacteremia remained stable during the last decade. The routine use of anaerobic BCs seems to be adequate, since in about half of the cases anaerobes could not be suspected on clinical bases. Moreover, prompt source control of infection is essential in order to reduce mortality of patients with anaerobic bacteremia.

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“…Individuals may improve without antimicrobial or surgical therapy, and others can get better because of adequate drainage. In some instances of polymicrobial infection, eradication of the aerobic component may be adequate, although it is well established that it is important to eliminate the anaerobic pathogens (2,(7)(8)(9)(10)(11)(12)(13)(14).…”

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confidence: 99%

“…There are a number of studies showing that inappropriate therapy will directly affect clinical outcome (10)(11)(12)(13)(14)(15).…”

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confidence: 99%

Antianaerobic Antimicrobials: Spectrum and Susceptibility Testing

2013

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SUMMARY Susceptibility testing of anaerobic bacteria recovered from selected cases can influence the choice of antimicrobial therapy. The Clinical and Laboratory Standards Institute (CLSI) has standardized many laboratory procedures, including anaerobic susceptibility testing (AST), and has published documents for AST. The standardization of testing methods by the CLSI allows comparisons of resistance trends among various laboratories. Susceptibility testing should be performed on organisms recovered from sterile body sites, those that are isolated in pure culture, or those that are clinically important and have variable or unique susceptibility patterns. Organisms that should be considered for individual isolate testing include highly virulent pathogens for which susceptibility cannot be predicted, such as Bacteroides , Prevotella , Fusobacterium , and Clostridium spp.; Bilophila wadsworthia ; and Sutterella wadsworthensis . This review describes the current methods for AST in research and reference laboratories. These methods include the use of agar dilution, broth microdilution, Etest, and the spiral gradient endpoint system. The antimicrobials potentially effective against anaerobic bacteria include beta-lactams, combinations of beta-lactams and beta-lactamase inhibitors, metronidazole, chloramphenicol, clindamycin, macrolides, tetracyclines, and fluoroquinolones. The spectrum of efficacy, antimicrobial resistance mechanisms, and resistance patterns against these agents are described.

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Routine Anaerobic Blood Cultures: Back Where We Started?

Cited by 23 publications

References 27 publications

Genotypic Diversity of Anaerobic Isolates from Bloodstream Infections

Genotypic Diversity of Anaerobic Isolates from Bloodstream Infections

Are incidence and epidemiology of anaerobic bacteremia really changing?

Antianaerobic Antimicrobials: Spectrum and Susceptibility Testing

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