Wound infections due to Bacteroides fragilis following intestinal surgery

Abstract

Ninety-six wound infections due to Bacteroides fragilis occurring after intestinal surgery are described. Most infections followed appendicectomy or colectomy for diverticulitis. B. fragilis was isolated in pure growth from 47 per cent of infections, and in mixed culture the other common bacteria were Klebsiella spp., Escherichia coli and Enterobacter spp. Fifty-three per cent of the infections responded rapidly to either non-specific measures or antibiotic therapy, but 47 per cent of patients developed complications, usually abscess formation. The successful isolation of bacteroides from clinical material requires special precautions. The specimen for bacteriological examination must be sent to the laboratory in a transport medium which maintains an anaerobic environment and the culture techniques must include a selective agar for the isolation of anaerobic bacteria. The role of antibiotic therapy in preventing postoperative wound infection after intestinal surgery is discussed. Bacteroides has an unusualy pattern of antibiotic susceptibility and it is essential that an effective antibiotic such as lincomycin is included in the treatment of infection originating from the intestinal tract.

Rapid Identification and Serotyping of ‘Bacteroides fragilis’ in Clinical Material by Direct Immunofluorescence

“…It is, therefore, important to examine the mixed cultures after sufficient time has elapsed for multiplication of the organisms (Table 2). Similar observations have been made by other workers (Marcoux et al 1970;Leigh 1975;Lorber & Swenson 1975).…”

Clinical Studies of 4 Methods of Bowel Preparation in Colorectal Surgery

“…This may be explained by the fact that when the 2 antibiotics are used together, not only are the anaerobes, for ex ample, directly attacked by metronidazole, but destruction of the aerobes by neomycin helps to disrupt faster the synergy shown experimentally to exist between the 2 groups of bacteria [14,21], thereby rendering the bacteria more vulnerable. Our finding dis agrees with the suggestion by Willis and Jones [25] and Leigh [15] that prophylaxis be directed only against anaerobes. It also con tradicts the experimental finding of Onderdonk et al [20] that metronidazole is active against aerobes.…”

“…The methods advocated range from mechanical washout alone as suggested by the study of Burdon et al [3] to the use of various forms and combinations of antibiot ics in addition to colon washout as advocated by many workers [ 15,24,25]. These methods are represented, at least in principle, by the 4 methods described in this study.…”

Die Behandlung der eitrigen Bauchfellentz�ndung

“…Wegen des unterschiedlichsten Krankengutes, der schwierigen Quantifizierbarkeit der Bauchfellentziindung und bei den verschiedenen, nicht standardisierten Behandlungsformen schwankt die Letalit/it zwischen 3 und 50 % [2,6,8,17]. Mit verbesserten Transport-und Kulturmedien und zus~itzlicher anaerober Technik lassen sich Anaerobier bei der eitrigen Peritonitis zunehmend nachweisen [1,9,11]. Mit verbesserten Transport-und Kulturmedien und zus~itzlicher anaerober Technik lassen sich Anaerobier bei der eitrigen Peritonitis zunehmend nachweisen [1,9,11].…”