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Review 2
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The page below is a sample from the LabCE course
Case Studies in Clinical Microbiology
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Review 2
Citron DM. Appelbaum PC.: How far should a clinical laboratory go in identifying anaerobic isolates, and who should pay?
Clinical Infectious Diseases. 16 Suppl 4:S435-8, 1993
Identification of anaerobic bacteria in specimens from sites of infection due to mixed organisms can be time-consuming and expensive. Laboratories should limit anaerobic workups by testing only those specimens that have been properly collected and transported to the laboratory.
Use of selective and differential media for initial processing can provide rapid and relevant information to the clinician. Anaerobes isolated from normally sterile sites and sites of serious infection should always be completely identified. Group-or genus-level identifications may suffice in other instances.
The
Bacteroides fragilis
group of organisms should always be identified because of their virulence and resistance to many antimicrobial agents.
Some of the other organisms that warrant identification include
Clostridium septicum
(associated with gastrointestinal malignancy);
Clostridium ramosum, Clostridium innocuum
, and
Clostridium clostridioforme
(which are resistant to antibiotics);
Clostridium perfringens
(a cause of myonecrosis and gas gangrene,potentially serious infection); anaerobic cocci (which may be resistant to metronidazole and clindamycin); and fusobacteria (which may be virulent and resistant to clindamycin and penicillin).
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