Anaerobic lower respiratory tract infections

Research output: Contribution to journalArticle

Abstract

Anaerobic bacteria are probably the most frequently overlooked common bacterial pathogens of the lower respiratory tract. The purpose of this report is to review the clinical and bacteriological features of 193 patients with this diagnosis. The types of pulmonary lesions were lung abscess (53 patients), necrotizing pneumonia (30) and pneumonitis without parenchymal necrosis (110); 51 of the patients had an associated empyema. The most common underlying condition was a pre-disposition to aspiration which was noted in 121 patients. The usual presenting findings were fever, leukocytosis, cough and sputum production. Only five patients were afebrile and all but 16 had peripheral leukocyte counts exceeding 8 000 μl. The median duration of symptoms prior to hospitalization was 7 days and 77 patients were noted to have putrid sputum or empyema fluid. The bacteriological diagnosis was established using specimens which are devoid of the normal flora of the upper airways including transtracheal aspirations in 142 patients, empyema fluid in 51 and thoracotomy specimens in 9; anaerobic bacteremia was noted in only 5 patients. Bacteriological results showed that 99 patients had an exclusively anaerobic flora while 94 patients had anaerobes in combination with potentially pathogenic aerobic bacteria. There were a total of 488 strains of anaerobes and 150 strains of aerobes. The predominant anaerobic, isolates were Bacteroides melaninogenicus (69), Fusobacterium nucleatum (63), anaerobic or microaerophilic streptococci (95), peptococci (44), and Bacteroides fragilis (38). Analysis of the bacteriological results according to the type of pulmonary lesion showed no unique patterns for patients with empyema, necrotic pulmonary parenchymal infection or pneumonitis. The primary modes of therapy were antimicrobials directed against the infecting flora and surgical drainage procedure in patients with empyema. The most frequent antimicrobials utilized were penicillins and clindamycin. Most of the patients with empyema required an open drainage and a delay in this procedure was associated with prolonged morbidity. Assessment of the overall results showed that 85% patients recovered and 15% expired.

Original languageEnglish (US)
Pages (from-to)118-122
Number of pages5
JournalScandinavian Journal of Infectious Diseases
Volume13
Issue numberSuppl. 26
StatePublished - 1981

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Respiratory Tract Infections
Empyema
Sputum
Lung
Drainage
Pneumonia
Peptococcus
Prevotella melaninogenica
Fusobacterium nucleatum
Lung Abscess
Bacteroides fragilis
Aerobic Bacteria
Anaerobic Bacteria
Clindamycin
Leukocytosis
Thoracotomy
Bacteremia
Streptococcus
Leukocyte Count
Cough

ASJC Scopus subject areas

  • Immunology
  • Microbiology (medical)

Cite this

Anaerobic lower respiratory tract infections. / Bartlett, John.

In: Scandinavian Journal of Infectious Diseases, Vol. 13, No. Suppl. 26, 1981, p. 118-122.

Research output: Contribution to journalArticle

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