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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.
Insights
Bacteroides fragilis causes many wound infections after intestinal surgery. Effective treatment requires anaerobic culture techniques and antibiotics like lincomycin to prevent complications such as abscesses.
Area of Science:
- Microbiology
- Surgical Infections
- Antibiotic Susceptibility
Background:
- Wound infections following intestinal surgery pose significant clinical challenges.
- Bacteroides fragilis is a common pathogen in these infections, often isolated with other enteric bacteria.
Purpose of the Study:
- To describe the characteristics of wound infections caused by Bacteroides fragilis after intestinal surgery.
- To evaluate the outcomes of different treatment strategies and highlight diagnostic considerations.
Main Methods:
- Retrospective analysis of 96 cases of wound infections post-intestinal surgery.
- Bacteriological analysis including anaerobic culture techniques and isolation of B. fragilis.
- Review of patient responses to non-specific measures and antibiotic therapy.
Main Results:
- Bacteroides fragilis was identified in 96 wound infections, frequently after appendicectomy or colectomy for diverticulitis.
- Mixed infections commonly involved Klebsiella spp., Escherichia coli, and Enterobacter spp.
- 47% of infections resolved with treatment, while 47% developed complications, primarily abscesses.
Conclusions:
- Successful isolation of Bacteroides requires specialized anaerobic transport and culture methods.
- Antibiotic therapy, including agents like lincomycin, is crucial for treating intestinal surgical wound infections due to Bacteroides' unique susceptibility patterns.