Bacteriology of Sinusitis of Odontogenic Origin
Odontogenic sinusitis is a well-recognized condition and accounts for approximately 10 to 12 of cases of maxillary sinusitis. Brook 16 studied the microbiology of 20 acutely and 28 chronically infected maxillary sinuses that were associated with odontogenic infection. Polymicrobial infection was very common with 3.4 isolates specimen and 90 of the isolates were anaerobes in both acute and chronic infections. The predominant anaerobic bacteria were AGNB, Peptostreptococcus spp., and...
Index
Abdominal infections, 233-243 Abdominal manifestation, actinomycosis and, 203, 205 Abscess es anorectal, 270-271 cutaneous, 267-269 dentoalveolar, 106-108 diabetic, 280 intra-abdominal, 240 liver, 233-234 pancreatic, 241-242 pelvic, 263 perinephric, 250-252 periodontitis, 15, 39,104-111,108-113, 215-216 pilonidal, 271-272 renal, 250-252 retroperitioneal, 235 spleenic, 235 tubo-ovarian, 263 Acidaminococcus, 8-9 Acne lesions, pustular, 273-274 Actinomyces, 1-9, 14, 15, 30, 89, 95, 103-106, 110,...
Microbiology and Pathogenesis
The predominant anaerobes causing meningitis are gram-negative bacilli including Bacteroides fragilis group , Fusobacterium spp. mostly F. necrophorum , and Clostridium spp. mostly Clostridium perfringens 1,2 . Peptostreptococcus spp., VeiUoneUa, Actinomyces, Propionibacterium acnes, and Eubacterium are less commonly isolated. The main predisposing conditions to anaerobic meningitis are ear, nose, and throat infections, gastrointestinal disease, and skull fractures. Less common causes are skull...
Pathogenesis Ctu
Predisposing conditions include trauma e.g., foreign body, corneal laceration, and contact lens , corneal exposure facial palsy, sedated or moribund state, globe prostosis, congenital abnormalities of the eyelids , immune deficiency immunodeficiency syndrome, immunosuppressive therapy, topical steroids , and abnormalities of ocular surface dryness, mucin deficiency, vitamin A deficiency, malnutrition, and corneal anesthesia . Anaerobic bacteria can reach the cornea from the mucous membranes in...
Permeability
Increased BL production was associated with decreased permeability in gram-negative bacteria. Permeability can vary among strains of B. fragilis 68,79,80 , and in some B. fragilis strains, resistance was associated with both reduced permeability and BL production 80 . Cefoxitin resistance correlated with a decrease in outer-membrane permeability and the loss of an outer-membrane protein with a molecular size of 49 to 50 kid 77 . Studies of pore-forming proteins of Bacteroides, Porphyromonas,...
Endometritis and Pyometra
Endometritis and pyometra are seen more commonly in older females who suffer from cervical canal obstruction or carcinoma or following delivery. However, they can also be seen occasionally in adolescent females. Endometritis occurs when bacteria invade the uterine cavity, and pyometra develops when pus is collected within the uterus. Regardless of the etiology, anaerobes are predominant in endometritis and pyometra. Hillier et al. 26 obtained endometrial biopsies for histologic and...
Lateral Pharyngeal Space
The lateral pharyngeal space is continuous with the carotid sheath. Involvement of this space may follow pharyngitis, tonsillitis, otitis, parotitis, and odontogenic infections. Anterior compartment involvement is characterized by fever, chills, pain, tremors, and swelling below the angle of the jaw. Posterior compartment infection is characterized by septicemia, often with few local signs. Other complications include edema of the larynx, asphyxiation, internal carotid artery, and erosion...
Macrolides Erythromycin Azithromycin Clarithromycin and Spiramycin
The macrolides, which possess low human or animal toxicity, have moderate to good in vitro activity against anaerobic bacteria other than B. fragilis and fusobacteria 13,53 . Macrolides are active against pigmented Prevotella and Porphyromonas and microaerophilic streptococci, gram-positive non-spore-forming anaerobic bacilli, and certain clostridia. They are less effective against Fusobacterium and Peptostreptococcus spp. 53 . They show relatively good activity against C. perfringens and poor...
References Hdo
1. Finch R. Skin and soft-tissue infections. Lancet 1988 1 8578 164-8. 2. Brook I, Frazier EH. Aerobic and anaerobic bacteriology of wounds and cutaneous abscesses. Arch Surg 1990 125 1445-51. 3. Meislin HW, Lerner SA, Graves MH, et al. Cutaneous abscesses anaerobic and aerobic bacteriology and outpatient management. Ann Intern Med 1977 7 145-9. 4. Rosebury T. Microorganisms Indigenous to Man. New York McGraw-Hill, 1962. 5. Brook I. Presence of beta-lactamase-producing bacteria and...
Pathogenesis Fhh
Because the mucous membranes lining the nasal chambers and the sinuses are alike histologically and are continuous with each other through the natural ostium, URTI commonly result in an inflammatory sinusitis. Sinusitis of nondental genesis is considered to be preceded by a viral, mechanical, or allergic stage when the nasal and paranasal mucosa are hyperemic and the permeability of the ostium is decreased. At that stage, the sealed-off sinus that fails to drain freely is prone to secondary...
Diagnosis Tyl
Specimens from the mastoid cells obtained during surgery and myringotomy fluid, when obtained, should be sent for cultures for both aerobic and anaerobic bacteria, Gram and acid-fast stains. If the tympanic membrane already is perforated, the external canal can be cleaned and a sample of the fresh drainage taken. Care must be taken to obtain fluid from the middle ear and not the external canal. Culture and susceptibility testing of the isolates can assist in modifying the initial empiric...
Myositis 1
Infectious myositis caused by bacteria can invade from contiguous sites such as skin and subcutaneous abscesses, ulcers, penetrating wounds, and osteomyelitis or through hematogenous spread. Trauma is a common cause in children 36,47 . Vascular insufficiency in an extremity can also facilitate the process. However, primary muscle abscess can also occur in the absence of a predisposing site of infection 48 . No conclusive evidence exists, which relate tropical pyomyositis causality to...
Skin and Subcutaneous Infection
Predisposing conditions to progressive bacterial synergistic gangrene include Table 3 surgery and draining sinus to synergistic necrotizing cellulitis diabetes, to streptococcal gangrene diabetes, myxedema, and prior abdominal surgery to clostridial myonecrosis gas gangrene trauma, to necrotizing cutaneous mucormycosis diabetes and corticosteroids therapy to Pseudomonas gangrenous cellulitis burns, and immunosuppression and to pyoderma gangrenosum ulcerative collitis and rheumatoid arthritis....
References Qkv
1. Long SS. Infant botulism. Pediatr Infect Dis J 2001 20 707-9. 2. Horowitz BZ. Botulinum toxin. Crit Care Clin 2005 21 825-39. 3. Goonetilleke A, Harris JB. Clostridial neurotoxins. J Neurol Neurosurg Psychiatry 2004 75 Suppl. 3 iii35-9. 4. Jajosky RA, Hall PA, Adams DA, et al. Summary of notifiable diseases United States, 2004. MMWR 2006 53 1-79. 5. Shapiro R, Hatheway CL, Swerdlow D. Botulism in the United States a clinical and epidemiologic review. Ann Intern Med 1998 129 221-8. 6. Sobel...
Etiology
Numerous reports have implied that the fecal microflora may contribute to the pathogenesis of NEC. A broad range of organisms generally found in the distal gastrointestinal tract have been recovered from the peritoneal cavity and blood of infants with NEC. Infectious agents recovered from newborns with endemic NEC are similar to those associated with epidemic NEC. Organisms cultured from the blood usually matched with those found in the stool 1,2,12 . Most reports describe the predominance of...
Dental Caries
The first step in the origination of caries is the formation of a dental plaque 2 . An increase in the amount of plaque is responsible for the ultimate development of gingivitis. A variety of factors interact in the generation of dental plaque and subsequent emergence of caries. These include the presence of a susceptible tooth surface, the proper microflora, and a suitable nutritional substrate for that flora. Several oral acid producing aerobic and anaerobic bacteria, including Streptococcus...
Myositis
S. aureus is the predominant cause of tropical and nontropical infection 34 . GABHS and other groups B, C, and G , as well as S. pneumoniae and Streptococcus anginosus can be recovered. Gram-negative aerobic and facultatives have also been rarely recovered. These include Enterobacteriaceae, Yersinia enterocolitica, Pseudomonas spp., Haemophilus influenzae, Neisseria gonorrhoeae, and Aeromonas spp. Anaerobic bacteria such as Bacteroides, Fusobacterium, Clostridium, and Peptostreptococcus spp....
Specific Antibiotics
Penicillin penetrates well into the abscess cavity and is active against non-beta-lactamase-producing anaerobes and some aerobic organisms. Chloramphenicol penetrates well into the intracranial space and is also active against Haemophilus spp., and most obligate anaerobes. Its use has been curtailed dramatically in most U.S.A. centers because of the availability of other equally efficacious and less toxic antimicrobial combinations i.e., cefotaxime plus metronidazole . Metronidazole penetrates...
The Newborns Maturity
Preterm babies are also colonized by facultatively anaerobic bacteria from the first days of life, and these remained at high levels resembling the full-term formula-fed babies. However, the intestinal colonization of preterm infants differed from that in full-term, breast-fed infants in the high counts of facultatively anaerobic bacteria and late appearance of bifidobacteria and from both groups of full-term infants in the early stable colonization by Bacteroides spp. 54 . It is postulated...
Tetanus
Tetanus is an acute toxemic illness caused by Clostridium tetani infection at a laceration or break in the skin. It can also complicate burns, puerperal infections, umbilical stump infections tetanus neonatorum , and surgical sites due to contaminated sutures, dressings, or plaster . Tetanus is an intoxication manifested mainly by neuromuscular dysfunction and caused by tetanal exotoxin tetanospasmin , a potent exotoxin elaborated by C. tetani. It begins with tonic spasms of the skeletal...
Nft Microbiology
S. pneumoniae, H. influenzae, Streptococcus agalactiae, and anaerobes are common in neonates. The most common pathogens in acute dacryocystitis in children are S. aureus, Streptococcus spp., and H. influenzae. The most frequently recovered organisms in chronic dacryocystitis are S. aureus, S. epidermidis, P. aeruginosa, Escherichia coli, and C. trachomatis. S. aureus, S. epidermidis, and rarely P. aeruginosa and E. coli have been reported in adults 14 . Anaerobic bacteria alone can be recovered...
Carbapenems Imipenem Meropenem and Ertapenem
Imipenem, a thienamycin, is a beta-lactam antibiotic that is effective against a wide variety of aerobic and anaerobic gram-positive and gram-negative organisms including normally multiresistant species such as P. aeruginosa, Serratia spp., Enterobacter spp., Acinetobacter spp., and enterococcus 41,42 . It also possesses excellent activity against beta-lactamase-producing Bacteroides. It has the lowest MIC for B. fragilis group and is also most effective against Entero-bacteriaceae. About 10-25...
Vulvovaginal Pyogenic Infections
Vulvovaginal pyogenic infections include abscesses of Bartholin's and Skene's glands, infected labial inclusion cysts, labial abscesses, furunculosis, and hidradenitis 6 . Most infections are related to both aerobic and anaerobic organisms arising from the normal vaginal and cervical flora. N. gonorrhoeae is responsible for approximately 10 of these infections. The majority of nonvenereal abscesses are caused by anaerobic bacteria. Parker and Jones 18 recovered anaerobes in two-thirds of 75...
Anaerobes as Part of the Human Indigenous Microbial Flora
The human mucous and epithelial surfaces are colonized with aerobic and anaerobic microorganisms 1 . These surfaces are the skin, conjunctiva, mouth, nose, throat, lower intestinal tract, vagina, and the urethra. The trachea, bronchi, esophagus, stomach, and upper urinary tract are not normally colonized by indigenous flora. However, a limited number of transient organisms may by present at these locations. Differences in the environment, such as oxygen tension and pH and variations in...
Mode of Delivery
Almost three-fourths of term infants delivered vaginally, whether formula-fed or breast-fed, are colonized with at least one aerobic gram-negative bacilli by 48 hours of age. In contrast, isolation rates before 48 hours was lower in term infants delivered by cesarean section and in premature infants delivered by the vaginal route. There are no differences in recovery of species of Clostridium, Bifidobacterium, Eubacterium, Fusobacterium, Propionibacterium, Lactobacillus, Peptostreptococcus, and...
Anaerobic Bacteria
Sinus infection when not treated promptly and properly may spread via anastomosing veins or by direct extension to nearby structures Fig. 5 . Orbital complication was categorized by Chandler et al. 67 into five separate stages according to its severity see chapter 11 . Contiguous spread could reach the orbital area, resulting in periorbital cellulitis, subperiosteal abscess, orbital cellulitis, and abscess. Orbital cellulitis may complicate acute ethmoiditis if a thrombophlebitis of the...
Ascending Cholangitis Following Portoenterostomy
Extrahepatic biliary atresia is an obliterative cholangiopathy that involves all or part of the extrahepatic biliary tree and, in many instances, the intrahepatic bile ducts. In the U.S.A., from 400 to 600 new cases of biliary atresia are encountered annually 46 . The diagnosis is usually suggested by the persistence of jaundice for six weeks or more after birth. Several factors have been considered for the pathogenesis of extrahepatic biliary atresia, including viral infection e.g.,...
Odontogenic Infections
The complexity of the oral and gingival flora has prevented the clear elucidation of specific etiologic agents in most forms of oral and dental infections. In the gingival crevice, there are approximately 1.8 X1011 anaerobes per gram 1 . Because anaerobic bacteria are part of the normal oral flora and outnumber aerobic organisms by a ratio of 1 10 to 1 100 at this site, it is not surprising that they predominant in dental infections. There are at least 350 morphological and biochemically...
Peptostreptococcus Spp In Cervical
Infectious CL can be either acute unilateral or bilateral, and chronic subacute . Because of the high frequency of CL in children, most microbiological studies were done in this age group. The most common causes of bilateral CL in children are viruses. However, the adenitis appears and resolves quickly without treatment. The most common viruses are EB, cytomegalovirus, herpes simplex, adeno virus, enterovirus, roseola, and rubella. Other pathogens include Mycoplasma pneumoniae and...
Pathogenesis Bdn
The dental pulp is normally protected from infection by oral microorganisms by the enamel and dentin. This barrier may be breached allowing entrance of bacteria into the pulp or periapical areas. This can occur through a cavity caused by dental caries, trauma, or dental procedures through the tubules of cut or carious dentin in periodontal disease by way of the gingival crevice and by invasion along the periodontal membrane by extension of periapical infection from adjacent teeth that are...
References Fsg
1. Finegold SM. Anaerobic Bacteria in Human Disease. New York Academic Press, 1977. 2. Gibbons RJ. Aspects of the pathogenicity and ecology of the indigenous oral flora of man. In Ballows A, Dehaan RM, Dowell VR, Guze LB, eds. Anaerobic Bacteria Role in Disease. Springfield, IL Thomas, 1974 267-85. 3. Bartlett JC, Gorbach SL, Thadepalli H, Finegold SM. Bacteriology of empyema. Lancet 1974 1 338-40. 4. Freij BJ, Kusmiesz H, Nelson GD, McCracken GH. Parapneumonic effusions and empyema in...
Microbiology Scn
The organisms that can be recovered from bite wounds generally are aerobic and anaerobic polymicrobial flora that originate from the oral cavity of the biting animal, the victim's own skin flora and the environment. Most infections are polymicrobial synergistic in nature. In studies where adequate methods were employed for the recovery of aerobic and anaerobic bacteria, anaerobes were isolated from over two-thirds of human and animal bite wound infections, especially those associated with...
Pulpitis
Pulpitis is an inflammation of the dental pulp that can result from thermal, chemical, traumatic, or bacterial irritation. The most frequent inducer of pulpitis is dental caries that leads to destruction of enamel and dentin resulting in bacterial invasion. Secondary infection of the pulp by supragingival anaerobes occurs frequently in teeth with longstanding caries. Invasion of the pulp and spread of infection to the periapical areas can promote spreading of infection to other anatomical...
Adult Intestinal Toxemia Botulism
Adult intestinal toxemia botulism occurs rarely and sporadically, and it results from the absorption of toxin produced in situ by botulinum toxin-producing Clostridia that colonizes the intestine. Generally, patients have an anatomical or functional bowel abnormality or are using antimicrobials, which may select fastidious Clostridium species from the normal bowel flora 30,35,36 . The symptoms may be protracted and relapsed even after treatment with antitoxin because of the ongoing intraluminal...
Spleenic Abscess
Abscess microbiology can be monomicrobial, polymicrobial, or sterile. Bacterial pathogens most commonly cause unilocular abscesses. Mycobacterial, fungal, or protozoan infections are detected less commonly overall but are most frequently seen in patients who are immunosup-pressed. The predominant aerobic and facultative isolates are E. coli, S. aureus, Proteus mirabilis, Enterococcus spp., and K. pneumoniae 5,6 . The predominant anaerobes were Peptostreptococcus spp., B. fragilis group,...
MICROBIOLOGY Impetigo
Most cases of impetigo and cellulitis are attributed to S. aureus and GABHS alone or in combination Table 2 19 . A retrospective study investigated both the aerobic and anaerobic Impetigo and cellulitis, diabetic, and chronic skin ulcers Streptococcus group A Staphylococcus aureus Anaerobic oral flora Prevotella, Fusobacterium, and Peptostreptococcus spp. around oral area and head and neck Colonic flora Enterobacteriaceae and anaerobes i.e., Escherichia coli and Bacteroides fragilis group...
References 1
1. Stoll BJ, Hansen N, Fanaroff AA, et al. Changes in pathogens causing early-onset sepsis in very-low-birth-weight infants. N Engl J Med 2002 347 240-7. 2. Tyler CW, Albers WH. Obstetric factors related to bacteremia in the newborn infants. Am J Obstet Gynecol 1996 94 970-6. 3. Chow AW, Leake RD, Yamauchi T, Anthony BF, Guze LB. The significance of anaerobes in neonatal bacteremia analysis of 23 cases and review of the literature. Pediatrics 1974 54 736-45. 4. Salem FA, Thadepalli H. Microbial...
References Cns
1. Finegold SM. Anaerobic Bacteria in Human Disease. New York Academic Press, 1977. 2. Brook I. Urinary tract infection caused by anaerobic bacteria in children. Urology 1980 16 596-8. 3. Kumazawa J, Kiyoara H, Narahashi K, Hidaka M, Momose S. Significance of anaerobic bacteria isolated from the urinary tract. I. Clinical studies. J Urol 1974 112 257-60. 4. Bartlett GJ, Gorbach SL. Anaerobic bacteria in suppurative infections of the male genitourinary system. J Urol 1981 125 376-8. 5. Mazuecos...
Branchial Cyst
The cyst represents the remnants of the first branchial cleft. It may occasionally open to the lateral wall of the pharynx on the palatopharyngeal fold or in the floor of the external auditory meatus at the junction of its cartilaginous and bony parts 104 . This type of cyst usually appears at the anterior border of the sternomastoid muscle at the junction of its middle and upper thirds. It is cystic and quite mobile, and its fluid contains cholesterol crystals. Treatment includes complete...
References Udj
1. Fliss DM, Leiberman A, Dagan R. Acute and chronic mastoiditis in children. Adv Pediatr Infect Dis 1997 13 165-85. 2. Van Zuijlen DA, Schilder AG, Van Balen FA, Hoes AW. National differences in incidence of acute mastoiditis relationship to prescribing patterns of antibiotics for acute otitis media Pediatr Infect Dis J 2001 20 140-4. 3. Nussinovitch M, Yoeli R, Elishkevitz K, Varsano I. Acute mastoiditis in children epidemiologic, clinical, microbiologic, and therapeutic aspects over past...
Differential Diagnosis
The most frequent admission diagnoses of infants later found to have IB include sepsis, viral syndrome, dehydration, cerebrovascular accident, failure to thrive, myasthenia gravis, poliomyelitis, Guillain-Barre syndrome, encephalitis, and meningitis. Several hereditary-endocrine or metabolic disorders considered are amino acid metabolism disorder, Werdnig-Hoffmann disease, and drug or toxin ingestion. Diagnoses less frequently considered include subdural effusion, infectious mononucleosis,...
References Hvj
1. Neu J. Neonatal necrotizing enterocolitis an update. Acta Paediatr Suppl 2005 94 100-5. 2. Torma MJ, Kafetzis DA, Skevaki C, Costalos C. Neonatal necrotizing enterocolitis an overview. Curr Opin Infect Dis 2003 16 349-55. 3. Stoll BJ. Epidemiology of necrotizing enterocolitis. Clin Perinatol 1994 21 205-18. 4. Llanos AR, Moss ME, Pinzon MC, Dye T, Sinkin RA, Kendig JW. Epidemiology of neonatal necrotising enterocolitis a population-based study. Paediatr Perinat Epidemiol 2002 16 342-9. 5....
Lincomycin and Clindamycin
The in vitro susceptibility of various anaerobic bacteria to lincomycin was initially demonstrated in 1965 56 . Subsequently, the 7-chloro-7-deoxylincomycin analog, clindamycin, was found to be even more active against anaerobes than the parent compound 13 . Lincomycin is highly active against a variety of anaerobic bacteria however, clostridia, B. fragilis, and F. varium are relatively resistant to lincomycin 13 . Clindamycin has a broad range of activity against anaerobic organisms and has...
Microbiology Jmi
Microorganisms usually gain access to burns directly because microbiota are normally present on the skin, and the skin is the interface with the outside world. The source of colonization of the burn wound usually is the patient's own endogenous flora as well as environmental organisms 4 . These organisms can reach the wound directly through the skin or the blood stream. Soon after a burn injury, surface cultures may reveal multiple organisms. Within three to five days, the wound will become...
Penicillin Binding Proteins
Penicillin binding to the penicillin binding proteins PBPs determines the efficacy of beta-lactam antimicrobial. Maintaining PBPs function in the final stage of cell wall synthesis is essential for bacterial growth. Beta-lactams work by binding to the active site of the essential PBP, causing cell death. Three to five PBPs can be found in Bacteroides strains a PBP 1 complex with one to three different enzymes, PBP 2, and PBP 3. These PBPs are most likely similar to the high-molecular-weight...
Elimination Of Gabhs
Antimicrobials that are effective against BLPB as well as GABHS have been shown to be effective in the elimination of GABHS in acute and chronic infections or the eradication of GABHS carrier state. These include lincomycin, clindamycin 54-69 , penicillin plus rifampin, and the combination of amoxicillin and clavulanic acid 65 Table 3 . Other drugs that may also be effective are the combination of metronidazole and a macrolide. Clindamycin was also found to be superior to penicillin in...
Paronychia
Paronychia is an inflammation of the structure surrounding the nails. Paronychia, whether acute or chronic, results from a breakdown of the protective barrier between the nail and the nail fold. The entry of organisms into the moist nail crevice results in the bacterial or fungal yeast or mold colonization of the area. It is common in housewives, cleaners, nurses, children who suck their fingers, or others who often have their hands in water 7 . Paronychia is more common in women than in men,...
Pericoronitis
Pericoronitis is an infection of the pericoronal soft tissue associated with gum flaps opercula that partially overlie the crown of the tooth. The teeth most often involved are the third mandibular molars. The infection is caused by microorganisms and debris that become entrapped in the gingival pocket between the tooth and the overlying soft tissue. If the overlying soft tissue becomes swollen, the drainage is obstructed and inflammatory exudate is entrapped and will spread to other anatomical...
Treatment Lcn
Prolonged antimicrobial therapy i.e., 6-12 months has typically been recommended for patients with all clinical forms of actinomycosis, to prevent disease recrudescence. However, individualization of courses of therapy is recommended, where the duration of antibiotics depends on the initial burden of disease, the site of infection, and the clinical and radiologic response to treatment. Adequate drainage is indicated if abscesses are present. Penicillin G is the drug of choice for treating an...
Clindamycin Resistance
Clindamycin has been used for the treatment of anaerobic infection since the 1960s. Resistance to clindamycin among anaerobes has slowly increased over time. The frequencies of resistance among anaerobes in the B. fragilis group in the U.S.A. was 3 in 1987, and increased to 16 , 26 , and 43 in 1996, 2000, and 2003, respectively 15-18 . However, resistance at some locations reached 44 19 . Results from one medical center cannot predict those at other centers as resistance to clindamycin in...