RaRoRoMiKi RaRoRoMiKi

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ANAEROBIC BACTERIA

CHARACTERICTICS:
Anaerobes generate energy by
fermentation (breakdown of sugar to
pyruvate)
Lack of the capacity to utilize O2 as a
terminal hydrogen acceptor
Some are sensitive to O2 concentration
as low as 0.5% O2
Most can survive in 3-5% O2
A few can grow poorly in the presence
of air
aerotolerant anaerobes (multiply in
the absence of oxygen like Clostridium
Histolyticum)
Many are members of the normal flora
created by presence of facultative
anaerobes
Obligate anaerobe- strictly no O2

OTHER CHARACTERISTICS
1. Part of normal flora
2. Can survive at O2 free
microenvironment of the body
3. Causes mix infection
4. Can grow on enrich media (reducing
agent) maintains redox potential

FACTORS THAT INHIBIT GROWTH OF
ANAEROBES BY OXYGEN
1. Toxic compounds are produce
- e.g. H2O2, superoxides
2. Absence of catalase and superoxide
dismutase
3. Oxidation of essential sulfhydryl groups
in enzymes without sufficient reducing
power to regenerate them

FACTORS RESPONSIBLE FOR THEIR VIRULENCE
Lipopolysaccharide
Promotes abscess formation,
enhanced coagulation
Polysaccharide capsule
Correlated with abscess
production
Enzymes
a. Collagenase
b. Heparinase
develop thrombophlebitis and
septic emboli
Short chain fatty acids
a. Butyrate seen on dental
plaque
b. Succinic acid- reduces
phagocytic killing
MULTIPLICATION OF THE OPPORTUNISTIC
PATHOGENS IS FACILITATED BY:
1. Inhibition of phagocytosis and intracellular
killing by PMN in the presence of
bacteroides by
a. Competition of opsonins
b. Inhibition of capsular materials
2. Protection of antibiotics, susceptibility
strains in mixtures thru destruction by the
beta lactamases
3. Utilization of O2 by facultative species that
aids in producing a suitable environment for
growth of anaerobe

Morphology
Gram
stain
Genus
Sporeforming
bacilli
+ Clostridium
Non-
sporeforming
bacilli
+
Actinomyces,
Bifidobacteria, Eubacteria,
Propionibacterium,
Mobilincus, Lactobacilli
-
Bacteroides,
Fusobacterium, Prevotella,
Porphyromas
Non-
sporeforming
cocci
+
Peptococci,
Peptostreptococci,
Streptococci
- Veilonella

CLINICAL MANIFESTATIONS
A. Clinical hints
1. Odor- foul smelling odor, fishy odor
2. Tissue- gas
3. Location- proximity with mucus membrane
4. Necrotic tissue- black, gangrenous
5. Endocarditis with (-) blood culture
6. Infection associated with malignancy
7. Black discoloration
8. Blood containing exudates
9. Associated with sulfur granules- small black
granules
10. Bacteremic feature with jaundice
11. Human Bites

B. Infection produced
1. Bacteremia
2. Brain abscess
3. Otogenic meningitis
4. Dental infection
5. Pulmonary Infection
6. Puerperal sepsis peptostreptococcus &
peptococcus
7. Chronic meningitis


RaRoRoMiKi RaRoRoMiKi

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LABORATORY DIAGNOSIS
A. Collection
- Anaerobes are endogenous in nature

I. Appropriate specimens for anaerobic culture
1. Pus
2. Pleural fluid thoracentesis
3. Urine Suprapubic aspiration
4. Pulmonary secretions
5. Uterine secretions or sinus tract material

II. Collection by needle aspiration is preferable
than swab culture because of:
a. Better survival of pathogen
b. Greater quantity of specimen
c. Less contamination with extraneous
organism are often achieved

B. Handling
- If swab must be used, a 2 tube system must be
used
a. 1st tube contains swab in O2 free CO2
b. 2nd tube contains PRAS (pre-reduced
anaerobically sterilized culture media)

Specimen should be placed in anaerobic
transport device with gas mixture

C. Isolation
Gram stain should be done in the
laboratory

a. Choice of appropriate media and
methods of culture
b. Quality control for the types of
bbacteria that laboratory culture reveal

A solid or liquid medium maybe used and
must provide an aerobic environment
anaerobic culture system (mechanically
reduces 02, CO2-terminal acceptor)

I. Anaerobic Jar
1. Candle jar
Reduces O2 environment
Only increases CO2 tension
2. Gas Pak Jar
a. Palladium aluminum coated pellets
Catalyst
Chemically reduces O2
Reacts with residual O2 in the
presence of h2 to form H2O
b. Gas Pak envelope
Generates CO2 and H2 gases
addition of 10 ml H2O = H2O2+CO2

c. Methylene blue strip
Indicator presence of O2
Blue (+) O2
White (-) O2

II. Anaerobic Glove Chamber
Close system
Used for premature babies e.g.incubator

III. Roll Tube
Has a pedal gas (CO2 & H2) would come out
place test tube directly to the outlets

METHODS FOR EXCLUDING OXYGEN
1. Fluid media containing fresh animal tissue
or 0.1% agar containing a reducing agent,
thioglycolate.
2. Anaerobic jar
3. Anaerobic glove chamber

D. Identification
- Plates are checked at:
18-24 hrs for faster growing species like
Clostridium perfringens & B. fragilis and
daily thereafter up to
5-7 days for slowly growing species lke
actinomyces, eubacterium and
propionbacterium

Genus is determined by:
Gram stain, cellular morphology, gas liquid
chromatography

Species determination is based on fermentation
of sugars and other biochemical determination

TREATMENT
Susceptibility testing should be done
Surgical drainage and resection of necrotic
tissue
debridement
Most are resistant to aminoglycosides
For bacteroides group, if resistant to
penicillin and cephalosporin, they may use:
a. Clindamycin
b. Metronidazole
c. Chloramphenicol


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ZombDAVID and RemingKENT!!