Anaerobic infections in children: a prospective study

The prevalence and significance of anaerobic infections in patients at St. Louis Children's Hospital were studied prospectively for a one-year period. Blood, selected body fluids, and aspirates obtained from abscesses or areas of cellulitis were cultured using special anaerobic collection and processing techniques. Infected peritoneal fluid from patients with gastrointestinal disease yielded a large proportion of all anaerobic isolates. The types of organisms isolated were common inhabitants of the intestinal tract. Anaerobic organisms were recovered from only 0.75% of all blood cultures; anaerobic bacteremia accounted for 5.8% of all clinically significant bacteremic episodes (8.7% in the neonatal period and 4.8% in children over 1 month of age). Serious anaerobic infections occurred more frequently in the compromised host or in newborn infants than in otherwise healthy children. Since anaerobic organisms cause a small proportion of infectious diseases in a general pediatric population, the cost of refined bacteriologic techniques for the isolation and identification of these organisms is not warranted in most community hospitals. However, such a program should be available in selected tertiary care centers to aid in the management of certain high-risk patients.