GENERAL BACKGROUND
LABORATORY
TREATMENT OPTIONS
- Anaerobes encompass a collection of G(+) and G(-) organisms that require a reduced oxygen environment for growth
- Anaerobes that cause infection in humans can survive in environments with more oxygen but cannot replicate in such conditions
- Some produce spores, while others do not; some have factors that increase their virulence compared to other anaerobes
- More than 100 species of anaerobes comprise normal human flora and are found in a number of areas, including skin, nose, mouth, throat, intestines, and vagina
- Infections are due to breakdown of relationship with the host and are often polymicrobial
- About 5% of all bacteremias are due to anaerobes
- Bacteroides is #1 cause, Clostridium #2 cause (perfringens and septicum species, not difficile)
- Source is abdominal in 50-70% of cases, female genital tract 5-20% of cases, and soft tissue 5-20% of cases
- Resistance is increasing to clindamycin, cefotetan, cefoxitin, cefotaxime, penicillin, and fluoroquinolones
- Resistance to carbapenems and beta lactamase/beta lactamase inhibitor combinations remains low
LABORATORY
- G(-) rod
TREATMENT OPTIONS
- Generally resistant to penicillin and ampicillin
- Over 90% are susceptible to beta lactam/beta lactamase inhibitor (amox/clav, ampicillin/sulbactam, piperacillin/tazobactam), metronidazole, moxifloxacin, and carbapenems