KillSinus Sinus Treatment Doctor Say Buy This Treatment
Cells of Fusobacterium spp. are moderately long and thin with tapered ends and have typical fusiform morphology. The species of Fusobacterium seen most often in clinical infections are Fusobacterium nucleatum, Fusobacterium necrophorum, Fusobacterium mortiferum, and Fusobacterium varium. F. nucleatum is the predominant Fusobacterium from clinical specimens, often associated with infections of the mouth, lung (38,60), and brain (37). They are often isolated from abscesses, obstetrical and gynecological infections, chest infections, blood, and wounds (77).
Since these organisms are part of the normal flora of the oral and gastrointestinal flora, they are found in almost all types of infections in children. These include bacteremia (11,32), meningitis associated with otologic diseases (37,44,45), peritonitis following rupture of viscus (18), and subcutaneous abscesses and burns near the oral or anal orifices (Fig. 3) (58,59).
- FIGURE 3 Gram stain of Fusobacterium nucleatum.
A growing resistance of anaerobic gram-negative bacilli previously susceptible to penicillins has been noticed in the last three decades (78,79). Resistance grew among members of the pigmented Prevotella and Porphyromonas, Fusobacterium spp., P. oralis, P. disiens, P. bivia, and P. oris-buccae. The main mechanism of resistance is through the production of the enzyme beta-lactamase. Complete identification and susceptibility testing and ability to produce beta-lactamase of members of the B. fragilis group as well as other anaerobic gramnegative bacilli are factors of practical importance when making choices between antimicrobials for the therapy of infections involving these organisms.
The recovery rate of the different anaerobic gram-negative bacilli in infected sites is similar to their distribution in the normal flora (1,7). While B. fragilis group were more often isolated in sites proximal to the gastrointestinal tract (abdomen, bile), pigmented Prevotella and Porphyromonas and Fusobacterium spp. were more prevalent in infections proximal to the oral cavity (bones, sinuses, chest), and P. bivia and P. disiens were more often isolated in obstetric and gynecologic infections. Knowledge of this common mode of distribution allows for logical choice of antimicrobials adequate for the therapy of infections in these sites.
Anaerobic cocci have been most often reported either as "anaerobic streptococci" or "anaerobic gram-positive cocci." These organisms were previously divided into Peptococcus spp. and Peptostreptococcus sp. However, they are currently all named Peptostreptococcus spp. and further divided according to species primarily on the basis of their metabolic products (76). The species most commonly isolated are Peptostreptococcus magnus (18% of all anaerobic gram-positive cocci isolated in Table 2), Peptostreptococcus asaccharolyticus (17%), Peptostreptococcus anaerobius (16%), Peptostreptococcus prevotii (13%), and Peptostreptococcus micros (4%) (2,3,76).
The infectious sites where anaerobic cocci predominate are in descending order of frequency: ear, bone, cysts, obstetric and gynecologic, abscesses, and sinuses. These organisms are part of the normal flora of the mouth, upper respiratory tract, intestinal tract, vagina, and skin (7). Their presence has been documented in adults in a variety of syndromes, including endocarditis, brain abscesses, puerperal sepsis, traumatic wounds, and postoperative necro-tizing fasciitis (2,3). They have been recovered in children in subcutaneous abscesses and burns around the oral and anal areas, intra-abdominal infections (18), decubitus ulcers (80), and also have been isolated as causes of bacteremia (11), and brain abscesses (37,81). These organisms are predominant isolates also in all types of respiratory infections in children and adults including chronic sinusitis (15), mastoiditis (16), acute (82,83) and chronic (14) otitis media, aspiration pneumonia (38,60), and lung abscess (60,61). They generally are recovered mixed with other aerobic or anaerobic organisms but in many cases, they are the only pathogens recovered. This may be of particular significance in cases of bacteremia (11,32,82) or acute otitis media (83).
Microaerophilic streptococci are not true anaerobes as they can become also tolerant after subculture, however they grow better anaerobically, and are often grouped under anaerobes in many studies. These organisms include the Streptococcus anginosus group (previously called Streptococcus milleri group, that include Streptococcus constellatus and S. intermedius), and Gemella morbillorum (previously called Streptococcus morbillorum) (84). Microaerophilic streptococci are of particular importance in chronic sinusitis (14) and brain abscess (37,81,85,86). They were also recovered from obstetric and gynecologic infections and abscesses(85,86).
There are three species described as anaerobic gram-negative cocci: Veillonella, Acidaminococcus, and Megasphaera. There are two described species of Veillonella and only one each of the other two genera. The veillonellae are the most frequently involved of the three species and are part of the normal flora of the mouth, vagina, and the small intestine of some persons (7). Although they rarely are isolated from clinical infections, these organisms have been recovered occasionally from almost every type of infection mostly mixed with other bacteria (3,87,88). Veillonella spp. were recovered from abscesses, aspiration pneumonias, endocarditis, meningitis, burns, bites, and sinuses.
Many infectious diseases can be produced by anaerobic bacteria. Anaerobes of major clinical importance tend to follow certain predictable patterns according to anatomic sites and their virulence. In the upper respiratory passages and lung, the major anaerobic pathogens are Peptostreptococcus spp., pigmental Prevotella and Porphyromonas spp., and Fusobacterium spp. In intra-abdominal infections and female genital infections, the most frequent isolates are of the B. fragilis group followed by anaerobic gram-positive cocci and Clostridium species.
Recognition of the pathogenic features of these organisms enables prompt identification and initiation of appropriate management of the infections that they cause.
- Jousimies H, Summanen P. Recent taxonomic changes and terminology update of clinically significant anaerobic gram-negative bacteria (excluding spirochetes). Clin Infect Dis 2002; 35(Suppl. 1):S17-21.
- Finegold SM. Anaerobic Bacteria in Human Disease. New York: Academic Press, 1977.
- Brook I. Recovery of anaerobic bacteria from clinical specimens in 12 years at two military hospitals. J Clin Microbiol 1988; 26:1181-8.
- Hatheway CL. Toxogenic clostridia. Clin Microbiol Rev 1990; 3:66-98.
- Aldape Mj, Bryant AE, Stevens DL. Clostridium Sordellii: epidemiology, clinical findings, and current perspectives in diagnosis and treatment. Clin Infect Dis 2006; 43:1436-46.
- Sunenshine RH, McDonald LC. Clostridium difficile-associated disease: new challenges from an established pathogen. Cleve Clin J Med 2006; 73:187-97.
- Bhatia R, Prabhakar S, Grover VK. Tetanus. Neurol India 2002; 50:398-407.
- Rosebury T. Microorganisms Indigenous to Man. New York: McGraw-Hill Book Company, 1966.
- Cashore WJ, Peter G, Lauermann M, Stonestreet BS, Oh W. Clostridium colonization and clostridial toxin in neonatal necrotizing enterocolitis. J Pediatr 1981; 98:308-11.
- Sturm R, Staneck JL, Stauffer LR, Neblett WW, III. Neonatal necrotizing enterocolitis associated with penicillin resistant Clostridium butyricum. Pediatrics 1980; 66:928-31.
- Cooperstock MS, Steffen E, Yolken R, Onderdonk A. Clostridium difficile in normal infants and sudden infant death syndrome: an association with infant formula feeding. Pediatrics 1982; 70:91-5.
- Brook I, Controni G, Rodriguez W, Martin WJ. Anaerobic bacteremia in children. Am J Dis Child 1980; 134:1052-6.
- Brook I, Gluck RS. Clostridium paraputrificum sepsis in sickle cell disease: a report of a case. South Med J 1980; 73:1644-5.
- Brook I, Schwartz RH, Controni G. Clostridium ramosum isolation in acute otitis media. Clin Pediatr 1979; 18:699-700.
- Brook I. Microbiology of chronic otitis media with perforation in children. Am J Dis Child 1980; 130:564-6.
- Brook I. Bacteriological features of chronic sinusitis in children. JAMA 1981; 246:967-9.
- Brook I. Aerobic and anaerobic bacteriology of chronic mastoiditis in children. Am J Dis Child 1981; 135:478-9.
- Brook I. Aerobic and anaerobic bacteriology of peritonsillar abscess in children. Acta Pediatr Scand 1981; 70:831-5.
- Brook I. Bacterial studies of peritoneal cavity and postoperative surgical wound drainage following perforated appendix in children. Ann Surg 1980; 192:208-12.
- Brook I. A 12 year study of aerobic and anaerobic bacteria in intra-abdominal and postsurgical abdominal wound infections. Surg Gynecol Obstet 1989; 169:387-92.
- Brook I, Frazier E. Microbiology of liver and spleen abscesses. J Med Microbiol 1998; 47:1075-80.
- Brook I, Frazier E. Aerobic and anaerobic microbiology of retroperitoneal abscesses. Clin Infect Dis 1998; 26:938-41.
- Brook I, Martin WJ, Finegold SM. Effect of silver nitrate application on the conjunctival flora of the newborn and the occurrence of clostridial conjunctivitis. J Pediatr Ophthalmol Strabismus 1978; 15:173-83.
- Brook I. Clostridial infection in children. J Med Microbiol 1995; 42:78-82.
- Sato J, Mochizuki K, Homma N. Affinity of the Bifidobacterium to intestinal mucosal epithelial cells. Bifidobacteria Microflora 1982; 1:51-4.
- Gorbach SL, Thadepalli H. Clindamycin in pure and mixed anaerobic infections. Arch Intern Med 1974; 134:87-92.
- O'Connor J, MacCormick DE. Mixed organism peritonitis complicating continuous ambulatory peritoneal dialysis. N Z Med J 1982; 95:811-2.
- Thomas AV, Sodeman TH, Bentz RR. Bifidobacterium (Actinomyces) eriksonii infection. Am Rev Respir Dis 1974; 110:663-8.
- Hata D, Yoshida A, Ohkubo H, et al. Meningitis caused by Bifidobacterium in an infant. Pediatr Infect Dis J 1988; 7:669-71.
- Vincent JW, Falkler WA, Suzuki JB. Systemic antibody response of clinically characterized patients with antigens of Eubacterium brachy initially and following periodontal therapy. J Periodontol 1986; 57:625-31.
- Hill GB, Ayers OM, Kohan AP. Characteristics and sites and infection of Eubacterium nodatum, Eubacterium timidum, Eubacterium brachy, and other asaccharolytic eubacteria. J Clin Microbiol 1987; 25:1540-5.
- Fainstein V, Elting LS, Bodey GP. Bacteremia caused by non-sporulating anaerobes in cancer patients. A 12-year experience. Medicine (Baltimore) 1989; 68:151-62.
- Brook I. Anaerobic bacterial bacteremia: 12-year experience in two military hospitals. J Infect Dis 1989; 160:1071-5.
- Cox SM, Phillips LE, Mercer LJ, Stager CE, Waller S, Faro S. Lactobacillemia of amniotic fluid origin. Obstet Gynecol 1986; 68:134-5.
- Sherman ME, Albrecht M, DeGirolami PC, et al. Lactobacillus: an unusual case of splenic abscess and sepsis in an immunocompromised host. Am J Clin Pathol 1987; 88:659-62.
- Brook I, Frazier EH. Significant recovery of nonsporulating anaerobic rods from clinical specimens. Clin Infect Dis 1993; 16:476-80.
- Brook I. Isolation of non-sporing anaerobic rods from infections in children. J Med Microbiol 1996; 45:21-6.
- Brook I. Microbiology and management of brain abscess in children. J Pediatr Neurol 2004; 2:125-30.
- Brook I, Finegold SM. Bacteriology of aspiration pneumonia in children. Pediatrics 1980; 65:1115-20.
- Brook I. Actinomycosis. In: Goldman L, Ausiello D, eds. Cecil Textbook of Medicine. 22nd ed. Philadelphia, PA: Saunders, 2004:1883-5 (chap. 337).
- Mourelatos K, Eady EA, Cunliffe WJ, Clark SM, Cove JH. Temporal changes in sebum excretion and propionibacterial colonization in preadolescent children with and without acne. Br J Dermatol 2007; 156:22-31.
- Brook I, Pettit TH, Martin WJ, Finegold SM. Aerobic and anaerobic bacteriology of acute conjunctivitis. Ann Ophthalmol 1978; 11:13-6.
- Elsner P. Antimicrobials and the skin physiological and pathological flora. Curr Probl Dermatol 2006; 33:35-41.
- Brook I. Presence of anaerobic bacteria in conjunctivitis associated with wearing contact lenses. Ann Ophthalmol 1988; 20:397-9.
- Heineman HS, Braude AI. Anaerobic infection of the brain. Observations on eighteen consecutive cases of brain abscess. Am J Med 1963; 35:682-97.
- Mathisen GE, Meyer RD, George WL, et al. Brain abscess and cerebritis. Rev Infect Dis 1984; 6:101-6.
- Dunkle LM, Brotherton TJ, Feigin RD. Anaerobic infections in children: a prospective study. Pediatrics 1976; 57:311-20.
- Goldberg MH. Corynebacterium: an oral-systemic pathogen. Report of cases. J Oral Surg 1971; 29:349-51.
- Finegold SM, Bartlett JG. Anaerobic pleuropulmonary infections. Cleve Clin J Med 1975; 42:101-11.
- Kaplan K, Weinstein L. Diptheroid infections of man. Ann Intern Med 1969; 70:919-29.
- Steinbok P, Cochrane DD, Kestle JR. The significance of bacteriologically positive ventriculoperitoneal shunt components in the absence of other signs of shunt infection. J Neurosurg 1996; 84:617-23.
- Brook I, Frazier EH. Infections caused by Propionibacterium species. Rev Infect Dis 1991; 13:819-22.
- Beeler BA, Crowder JG, Smith JW, White A. Propionibacterium acnes: pathogen in central nervous system shunt infection. Report of three cases including immune complex glomerulo-nephritis. Am J Med 1976; 61:935-8.
- Purdy S, deBerker D. Acnes. BMJ 2006; 333:949-53.
- Brook I. Infection caused by Propionibacterium in children. Clin Pediatr 1994; 33:486-90.
- Nakano V, Padilla G, do Valle Marques M, Avila-Campos MJ. Plasmid-related beta-lactamase production in Bacteroides fragilis strains. Res Microbiol 2004; 155:843-6.
- Holdeman LV, Cato EP, Moore WE. Taxonomy of anaerobes: present state of the art. Rev Infect Dis 1984; 6(Suppl. 1):S3-10.
- Botta GA, Arzese A, Minisini R, Trani G. Role of structural and extracellular virulence factors in gramnegative anaerobic bacteria. Clin Infect Dis 1994; 18:S260-4.
- Brook I, Frazier EH. Aerobic and anaerobic bacteriology of wounds and cutaneous abscesses. Arch Surg; 1990; 125:1445-51.
- Mousa HA. Aerobic, anaerobic and fungal burn wound infections. J Hosp Infect 1997; 37:317-23.
- Bartlett JG. Anaerobic bacterial infections of the lung and pleural space. Clin Infect Dis 1993; 16(Suppl. 4):S248-55.
- Brook I, Finegold SM. The bacteriology and therapy of lung abscess in children. J Pediatr 1979; 94:10-4.
- Brook I, Barrett CT, Brinkman CR, III, Martin WJ, Finegold SM. Aerobic and anaerobic flora of maternal cervix and newborn's conjunctiva and gastric fluid: a prospective study. Pediatrics 1979; 63:451-5.
- Brook I, Martin WJ, Finegold SM. Neonatal pneumonia caused by members of the Bacteroides fragilis group. Clin Pediatr 1980; 19:541-4.
- Brook I. Bacteriology of neonatal omphalitis. J Infect 1982; 5:127-31.
- Brook I. Osteomyelitis and bacteremia caused by Bacteroides fragilis: a complication of fetal monitoring. Clin Pediatr 1980; 19:639-40.
- Finegold SM, Jousimies-Somer H. Recently described clinically important anaerobic bacteria: medical aspects. Clin Infect Dis 1997; 25(Suppl. 2):S88-93.
- Brook I, Gillmore JD, Coolbaugh JC, Walker RI. Pathogenicity of encapsulated Bacteroides melanino-genicus group, Bacteroides oralis, and Bacteroides ruminicola in abscesses in mice. J Infect 1983; 7:218-26.
- Brook I. Microbiology of human and animal bite wounds. Pediatr Infect Dis J 1987; 6:29-32.
- Brook I. Paronychia: a mixed infection. Microbiology and management. J Hand Surg [Br] 1993; 18:358-9.
- Brook I. Urinary tract infection caused by anaerobic bacteria in children. Urology 1980; 16:596-8.
- Brook I, Frazier EH. Anaerobic osteomyelitis and arthritis in a military hospital: a 10-year experience. Am J Med 1993; 94:21-8.
- Kilian M, Frandsen EV, Haubek D, Poulsen K. The etiology of periodontal disease revisited by population genetic analysis. Periodontol 2000 2006; 42:158-79.
- Brook I, Frazier EH, Gher ME. Aerobic and anaerobic microbiology of periapical abscess. Oral Microbiol Immunol 1991; 6:123-5.
- Okuda K, Takazoe I. Antiphagocytic effects of the capsular structure of a pathogenic strain of Bacteroides melaninogenicus. Bull Tokyo Med Dent Univ 1973; 14:99-104.
- Brook I. Prevotella and Porphyromonas infections in children. J Med Microbiol 1995; 42:340-7.
- Jousimies-Somer HR, Summanen P, Baron EJ, Citron DM, Wexler HM, Finegold SM. Wadsworth-KTL Anaerobic Bacteriology Manual. 6th ed. Belmont, CA: Star Publishing, 2002.
- Brook I. Fusobacterial infections in children. J Infect 1994; 28:155.
- Brook I, Calhoun L, Yocum P. Beta lactamase producing isolates of Bacteroides species from children. Antimicrob Agents Chemother 1980; 18:164-6.
- Brook I. Infections caused by beta-lactamase-producing Fusobacterium spp. in children. Pediatr Infect Dis J 1993; 12:532-4.
- Montgomerie JZ, Chan E, Gilmore DS, Canawati HN, Sapico FL. Low mortality among patients with spinal cord injury and bacteremia. Rev Infect Dis 1991; 13:867-71.
- Brook I, Friedman E, Rodriguez WJ, Controni G. Complications of sinusitis in children. Pediatrics 1980; 66:568-72.
- Brook I. Peptostreptococcal infection in children. Scand J Infect Dis 1994; 26:503-10.
- Brook I, Anthony BF, Finegold SM. Aerobic and anaerobic bacteriology of acute otitis media in children. J Pediatr 1978; 92:13-6.
- Belko J, Godmann DA, Macone A, Zaidi AK. Clinical significant infections with organisms of Streptococcus milleri group. Pediatr Infect. Dis J 2002; 21:715-23.
- Brook I. Microaerophilic streptococcal infection in children. J Infect 1994; 28:241-9.
- Brook I, Frazier EH. Microaerophilic streptococci as a significant pathogen: a twelve-year review. J Med 1994; 25:129-44.
- Brook I. Veillonella infections in children. J Clin Microbiol 1996; 34:1283-5.
- Brook I, Frazier E. Infections caused by Veillonella species. Infect Dis Clin Prac 1992; 1:377-81.
Was this article helpful?