NON-SPORING ANAEROBES

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• NON-SPORING ANAEROBES
• Prof. Khalifa Sifaw Ghenghesh

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• Part of the Normal Microbial Flora
• In the mouth and oropharynx, gastrointestinal
  tract and female genital tract of healthy
  individuals.
• Gramve and Gram ve cocci, rods and filaments,
  as well as spiral forms.
• Wide Variety of Infections
• Wound infections
• Periodontal disease
• Most infections are of endogenous origin and
  polymicrobial (exception gt clostridia)
• Infections in damaged and necrotic tissues, or in
  the immunocompromised.

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• Some clinical signs and indicators of
  non-clostridial
• anaerobic infections
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• Foul-smelling pus, discharge or lesion
• Production of a large amount of pus (abscess
  formation)
• Proximal of lesion to mucosal surface or portal
  of entry
• Failure to isolate organism from pus (sterile
  pus)
• Infection associated with necrotic tissue
• Deep abscess
• Gas formation in tissues
• Failure to respond to conventional antimicrobial
  therapy
• Pus which shows red fluorescence under UV light
• Detection of sulphur granules in pus
  (actinomycosis)
• Infection of human or animal wound bite
• Gram-negative bacteraemia
• Septic thrombophlebitis

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Polymicrobial Flora

• Mixed infections varies according the site
  affected.
• 2-12 species or more are involved.
• May include strict and facultative anaerobes and
  microaerophilic organisms.
• Frequently comprise mixtures of Gram ve rods
  (e.g. Bacteroides, Prevotella and Fusobacterium
  species) and Gramve cocci (peptostreptococci or
  streptococci or both)

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Non-Sporing Gram-Negative Rods

• Fusobacterium species
• Oral origin (mainly)
• Colonize the mucous membranes of humans and
  animals
• Commensals of upper respiratory and
  gastrointestinal tracts.
• Fusobacterium nucleatum
• Leptotrichia species
• Leptotrichia buccalis
• Vincents gingivitis

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• Bacteroides species and Related Gram ve rods. 3
  Groups
• Saccharolytic group gtgt Most important
• Bacteroides fragilis (group)
• Intrabdominal and soft tissue infections below
  the waist
• Moderately Saccharolytic group
• Prevotella melaninogenica
• Asaccharolytic group
• Porphyromonas asaccharolytica
• Porphyromonas gingivalis
• Periodontitis

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Bacteroides fragilis ssp. fragilis cultured in
blood agar medium for 48 hours.
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Bacteroides fragilis
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Fusobacterium sp.
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Gram-Positive Anaerobic Cocci

• Genus Peptostreptococcus
• P. asaccharolyticus
• P. vaginalis
• Infections in various parts of the body
• Abscesses

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• Types of Infection and Clinical Specimens from
• which Anaerobic Gramve Cocci are Isolated
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• Blood cultures
• Central nervous system (including brain
  abscesses)
• Head and neck infections (including ear)
• Dental abscesses and infected root canal
• Periodontal diseases
• Human and animal bites
• Pleural infections
• Abdominal infections
• Genito-urinary tract infections
• Decubitus ulcers
• Foot ulcers
• Osteomyelitis
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Gram-Negative Anaerobic Cocci

• Genus Veillonella
• Normal flora of GIT
• A regular component of supragingival plaque and
  the tongue microflora
• A minor component of mixed anaerobic infection

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Non-Sporing Gram-Positive Rods

• Present in significant numbers in normal flora of
  the mouth, skin, GI and female genito-urinary
  tracts
• Propionibacterium
• Bifidobacterium
• Lactobacillus
• Actinomyces
• Eubacterium

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• Infection of the lachrymal canal (lachrymal
  canaliculitis)
• Some species are found in acne
• Occasionally isolated in infective endocarditis
  and infection associated with implaned prostheses

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Spiral-Shaped, Motile organisms

• Several Treponema species found in the mouth
• Mixed anaerobic infections
• Acute necrotizing ulcerative gingivitis

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Laboratory Diagnosis

• Adequate clinical specimens are collected
  (preferably under reducing conditions) and
  rapidly transported to bacteriology laboratory.
• Microscopical examination
• Cultured on proper media and under anaerobic
  conditions
• Gas-liquid chromatography
• Direct on pus and other clinical materials

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Treatment

• Surgical
• Drainage of pus from abscess, debridement,
  curettage and removal of necrotic tissue
• Antibiotics
• Penicillin, Metronidazole