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Anaerobic infections in children: a prospective survey
Abstract:
Over an 18-month period, cultures from 95 infants and children yielded 146 anaerobic organisms in 110 clinical specimens. Bacteroides was the most frequently isolated anaerobe, followed by Propionibacterium and Clostridium species. Intra-abdominal sources, soft tissues, and blood were the three major sources (82%) of isolation of anaerobes. Whereas most patients (58%) were over 5 years of age and only 11% were newborns, anaerobic infections constituted a rather uniform proportion of all infections, regardless of sources, in all age groups. Anaerobes accounted for only 2.9% of all positive cultures encountered from the various sources. Rates of recovery of anaerobes from intra-abdominal sources were significantly the highest, and from soft-tissue infections they were significantly the lowest. The anaerobic bacteremias observed were of no clinical significance when Propionibacterium species were isolated; however, recovery of other anaerobes from the blood, and primarily Bacteroides species, was usually associated with clinical disease. Except in blood cultures, anaerobes almost invariably coexisted with facultative bacteria.
Insights
Anaerobic bacteria, primarily Bacteroides, are frequently isolated from intra-abdominal infections and soft tissues in children. While often co-infecting with other bacteria, their presence indicates clinical disease, especially in blood cultures.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Pediatric Infections
Background:
- Anaerobic bacteria are significant pathogens in pediatric infections.
- Understanding the prevalence and sources of anaerobic organisms is crucial for effective treatment.
Purpose of the Study:
- To characterize the epidemiology of anaerobic bacterial isolates in pediatric clinical specimens.
- To identify common sources and associated clinical significance of anaerobic infections in children.
Main Methods:
- Retrospective analysis of 110 clinical specimens from 95 pediatric patients over 18 months.
- Identification and quantification of anaerobic organisms, including Bacteroides, Propionibacterium, and Clostridium species.
- Correlation of isolate recovery with infection sources, patient age, and clinical outcomes.
Main Results:
- 146 anaerobic organisms were isolated, with Bacteroides being the most common, followed by Propionibacterium and Clostridium.
- Intra-abdominal sites, soft tissues, and blood were the predominant sources (82%) of anaerobic isolates.
- Anaerobic infections represented 2.9% of all positive cultures, with higher recovery rates from intra-abdominal infections and lower rates from soft-tissue infections.
Conclusions:
- Anaerobic bacteria, particularly Bacteroides species, are important pathogens in pediatric infections, frequently originating from intra-abdominal sites.
- While anaerobes are often co-isolated with facultative bacteria, their presence, especially Bacteroides in blood, is typically associated with significant clinical disease.
- Propionibacterium bacteremia showed no clinical significance, highlighting the need for species-specific interpretation of anaerobic isolates.