The role of anaerobic bacteria in bacteremia

Anaerobic bacteria remain an important cause of bloodstream infections and account for 1–17% of positive blood cultures. This review summarizes the epidemiology, microbiology, predisposing conditions, and treatment of anaerobic bacteremia (AB) in newborns, children, adults and in patients undergoing dental procedures. The majority of AB are due to Gram-negative bacilli, mostly Bacteroides fragilis group. The other species causing AB include Peptostreptococcus, Clostridium spp., and Fusobacterium spp. Many of these infections are polymicrobial. AB in newborns is associated with prolonged labor, premature rupture of membranes, maternal amnionitis, prematurity, fetal distress, and respiratory difficulty. The predisposing conditions in children include: chronic debilitating disorders such as malignant neoplasm, hematologic abnormalities, immunodeficiencies, chronic renal insufficiency, or decubitus ulcers and carried a poor prognosis. Predisposing factors to AB in adults include malignant neoplasms, hematologic disorders, transplantation of organs, recent gastrointestinal or obstetric gynecologic surgery, intestinal obstruction, diabetes mellitus, post-splenectomy, use of cytotoxic agents or corticosteroids, and an undrained abscess. Early recognition and appropriate treatment of these infections are of great clinical importance.     

The role of encapsulated anaerobic bacteria in synergistic infections

Abstract: The effect of encapsulation on the virulence, survival, and protection of anaerobic bacteria from phagocytosis is reviewed. Support for the importance of encapsulated Gram-negative anaerobic rods ( Bacteroides sp., Prevotella sp. and Porphyromonas sp.), anaerobic and facultative Gram-positive cocci (AFGPC) was provided by their higher recovery rate in oropharyngeal infections, abscesses and blood, compared to their number in the normal flora. The pathogenicity of Bacteroides, Fusobacterium, Clostridium , and AFGPC was studied by inoculating them into mice and observing their ability to induce subcutaneous abscesses. Encapsulated Bacteroides, Fusobacteria , and AFGPC generally induced abscesses, whereas non-encapsulated organisms did not. However, many of the strains that had only a minimal number of encapsulated organisms (< 1%) survived in the abscesses, and they became heavily encapsulated when inoculated with other viable or non-viable encapsulated bacteria. Thereafter, these strains were able to induce abscesses when injected alone. Encapsulated Gram-negative anaerobic rods and AFGPC-induced bacteraemia and translocation, and increased the mortality of the infected animals more often than did the non-encapsulated form of the same strains. As determined by using selective antimicrobial therapy and quantitative cultures of abscesses induced in mice, possession of a capsule generally made Gram-negative anaerobic rods more important than their aerobic counterparts. Synergistic potentials were seen between encapsulated Gram-negative anaerobic rods and all tested aerobic bacteria and most AFGPC, and also between most AFGPC and Pseudomonas aeruginosa or Staphylococcus aureus . These studies demonstrated the importance of encapsulated anaerobes in mixed infections.     

The role of anaerobic bacteria in chronic suppurative otitis media in children: Implications for medical therapy

This review describes the microbiology, diagnosis and medical management of chronic suppurative otitis media (CSOM) in children highlighting the role of anaerobic bacteria. In studies that employed adequate method for recovery of anaerobic bacteria polymicrobial aerobic and anaerobic flora was isolated from over half of the children with CSOM. The predominant aerobic isolates were Staphylococcus aureus and Pseudomonas aeruginosa and the most frequently isolated anaerobic organisms were Peptostreptococcus, Fusobacterium spp. and pigmented Prevotella and Porphyromonas spp. Several studies illustrated the efficacy of anti-infective agents effective against anaerobic bacteria in the treatment of CSOM. The medical therapy of CSOM should be directed at the eradication of the pathogenic aerobic and anaerobic organisms.     

The role of enteric bacteria in the anaerobic metabolism of 5-aminosalicylate

The primary (and inactive) enteric metabolite of 5-aminosalicylate is N-acetyl-5-aminosalicylate. Previous studies have demonstrated acetylation of this anti-inflammatory agent by intestinal and bacterial homogenates. To assess the contribution of anaerobic bacteria to the N-acetylation in vivo, we have measured the production of N-acetyl-5-aminosalicylate in anaerobic microculture. Our results indicate that enteric bacteria play a minor role in N-acetylation, but may contribute to the production of other metabolites of pharmacologic and toxicological interest.     

The role of anaerobic bacteria in cutaneous and soft tissue abscesses and infected cysts

This review presents the aerobic and anaerobic microbiological aspects and management of cutaneous and soft tissue abscesses, paronychia, anorectal, pilonidal, and perirectal abscesses, infected epidermal cysts, hidradenitis suppurativa, and pustular acne lesions. These infections often occur in different body sites or in areas that have been compromised or injured by foreign body, trauma, ischemia, malignancy or surgery. In addition to group A beta-hemolytic streptococci and Staphylococcus aureus, the indigenous aerobic and anaerobic cutaneous and mucous membranes local microflora usually is responsible for these generally polymicrobial infections. These infections may occasionally lead to serious potentially life-threatening local and systemic complications. The infections can progress rapidly and early recognition and proper medical and surgical management is the cornerstone of therapy.     

The role of nonsporulating anaerobic bacteria in the etiology of postabortion and postpartal endometritis

As the result of the study carried out by the authors, a conclusion has been made on the leading role of polymicrobial aerobic-anaerobic complexes, capable of producing a synergic effect, in the etiology of endometritis, anaerobic microorganisms prevailing in their importance. In the etiology of endometritis the most important organisms are bacteroids and peptostreptococci among anaerobes, enterobacteria and group D streptococci among aerobes. Anaerobic bacteria causing endometritis are most sensitive to dalacin and lincomycin, least sensitive to benzylpenicillin, resistant to aminoglycosides. The amounts of aerobic and anaerobic microflora contaminating the uterine cavity correlate with the severity of endometritis.     

The taxonomy of obligate anaerobic bacteria

Studies on the chemotaxonomy of obligate anaerobic bacteria have been made. The combination of gas chromatography and mass spectrometry with computer-assisted analysis, permitting the multicomponent analysis of all products of bacterial metabolism and bacterial cell components, has been shown to be a research method, quite suitable for such studies. The chromatographic profiles of the end products of metabolism in anaerobic cultures of different age have been found to differ not in the set and number of peaks indicating various metabolites, but only in the concentration of metabolites, increasing in the process of prolonged incubation. The authors believe that the national microbiological "library" of the chromatographic profiles of anaerobic organisms should be created and the album of typing chromatographic profiles should be published; besides, data on new profiles should regularly appear in magazines.     

Corrinoids in anaerobic bacteria

Abstract C₁-metabolizing bacteria were analyzed for their corrinoids. The autotrophic phototrophe Chloroflexus aurantiacus contains predominantly the light-sensitive coenzyme B₁₂. The corrinoid could be teh prostethic group of a methylmalonyl-CoA mutase, which is involved in the CO₂ fixing reaction sequence from proplonyl-CoA to succinyl CoA. Methanobacterium thermoautotrophicum and Sporomusa ovata contain only traces of light-sensitive corrinoids, indicating that the demethylation reaction is favored, if these corrinoids are involved in methyl transfer reactions. The chemical structure of the unique p -cresolyl cobamide is specific for the acetogenic bacterium S. ovata , rather than the corrinoid 'factor III' for methanogenic bacteria.     

The cellulosome and cellulose degradation by anaerobic bacteria

Despite its simple chemical composition, cellulose exists in a number of crystalline and amorphous topologies. Its insolubility and heterogeneity makes native cellulose a recalcitrant substrate for enzymatic hydrolysis. Microorganisms meet this challenge with the aid of a multi-enzyme system. Aerobic bacteria produce numerous individual, extra-cellular enzymes with binding modules for different cellulose conformations. Specific enzymes act in synergy to elicit effective hydrolysis. In contrast, anaerobic bacteria possess a unique extracellular multi-enzyme complex, called cellulosome. Up to 11 different enzymes are aligned on the non-catalytic scaffolding protein and thus ensure a high local concentration, together with the correct ratio and order of the components. These multi-enzyme complexes attach both to the cell envelope and to the substrate, mediating the proximity of the cells to the cellulose. Binding to the scaffolding stimulates the activity of each individual component towards the crystalline substrate. The most complex and best investigated cellulosome is that of the thermophilic bacterium Clostridium thermocellum, but a scheme for the cellulosomes of the mesophilic clostridia and the ruminococci emerges. Many crucial details of cellulose hydrolysis are still to be uncovered. Yet, a mechanistic model for the action of enzyme complexes on the surface of insoluble substrates becomes apparent and the application of enzymatic hydrolysis of cellulosic biomass can now be addressed.     

Citrate metabolism in anaerobic bacteria

Abstract The regulation of anaerobic citrate metabolism is very diverse among different groups of bacteria. In organisms like Streptococcus lactis and Clostridium sporosphaeroides which lack citrate synthase, the activity of its antagonistic enzyme, citrate lyase, need not be regulated. Many anaerobes like Rhodocyclus gelatinosus and Clostridium sphenoides are able to synthesize their own l -glutamate and contain citrate synthase. In these bacteria the activity of citrate metabolizing enzymes which are involved in a cascade system are under strict control. In Rc. gelatinosus activation/inactivation of citrate lyase is controlled by acetylation/deacetylation which is catalyzed by its corresponding regulatory enzymes, citrate lyase ligase and citrate lyase deacetylase. In C. sphenoides inactivation of citrate lyase is accomplished by deacetylation as well as by changing in the enzyme conformation. Activation of citrate lyase is catalyzed by citrate lyase ligase whose activity in addition is modulated by phosphorylation/dephosphorylation. Further, electron transport process also seems to play a role in the inactivation of citrate metabolizing enzymes in enteric bacteria.     

Unusual dehydrations in anaerobic bacteria

Abstract In amino acid fermenting anaerobic bacteria a set of unusual dehydratases is found which use 2-hydroxyacyl-CoA, 4-hydroxybutyryl-CoA or 5-hydroxyvaleryl-CoA as substrates. The extremely oxygen-sensitive 2-hydroxyacyl-CoA dehydratases catalysing the elimination of water from ( R )-lactyl-CoA to acryloyl-CoA or from ( R )-2-hydroxyglutaryl-CoA to glutaconyl-CoA contain iron-sulfur clusters as well as riboflavin and require additional activation by ATP. The dehydration of 4-hydroxybutyryl-CoA to crotonyl-CoA is catalysed by a moderately oxygen-sensitive enzyme also containing an iron-sulfur cluster and FAD. In all these reactions a non-activated C-H-bond at C₃ has to be cleaved by mechanisms not yet elucidated. The dehydration of 5-hydroxyvaleryl-CoA to 4-pentenoyl-CoA, however, has been characterised as a redox process mediated by enzyme-bound FAD. Finally, an iron-sulfur cluster-containing but pyridoxal-phosphate-independent l -serine dehydratase is described.     

Interactions between amino-acid-degrading bacteria and methanogenic bacteria in anaerobic digestion

The degradation of amino acids in anaerobic digestion was examined in terms of the interactions between amino-acid-degrading bacteria and methanogenic bacteria. Certain amino acids were degraded oxidatively by dehydrogenation, with methanogenic bacteria acting as H(2) acceptors. The inhibition of methanogenesis by chloroform also inhibited the degradation of these amino acids and/or caused variations in the composition of volatile acids produced from them. The presence of glycine reduced the inhibitory effect caused by chloroform, probably because glycine acted as an H(2) acceptor in place of methanogenic bacteria. This fact suggested that the coupled oxidation-reduction reactions between two amino acids-one acting as the H(2) donor and the other acting as the H(2) acceptor-may occur in the anaerobic digestion of proteins or amino-acid mixtures. The conversion of some proteins to volatile acids was not affected when methanogenesis was inhibited by chloroform. This suggested that the component amino acids of proteins may be degraded by the coupled oxidation-reduction reactions and that the degradation of proteins may not be dependent on the activity of methanogenic bacteria as H(2) acceptors.     

The identification of anaerobic bacteria using MALDI-TOF MS

Matrix Assisted Laser Desorption and Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) has gained more and more popularity for the identification of bacteria. Several studies show that bacterial diagnosticis is being revolutionized by the application of MALDI-TOF MS. For anaerobic bacteria, MALDI-TOF MS has been used for the identification of Prevotella spp., Fusobacterium spp., Clostridium spp., Bacteroides spp. and Gram-positive anaerobic cocci. However, to identify bacteria reliably, an extensive database is essential. For routine identification of anaerobic bacteria available databases need to be optimised.     

Energy conservation in chemotrophic anaerobic bacteria

[This corrects the article on p. 100 in vol. 41.].     

Competitive reaction kinetics of sulfate-reducing bacteria and methanogenic bacteria in anaerobic filters

A kinetic model for the anaerobic filter (AF) that takes into account the mass fractions of sulfate-reducing bacteria (SRB) (f(SRB)) and methanogenic bacteria (MB) (f(MB)) and an inhibiting effect of H(2)S on bacterial groups is proposed. When the acetate-fed AFs were maintained at the low organic loading rate of 2.5kg COD/m(3)d, variations of the influent COD/SO(4)(2-) ratio (0.5-3.0) does not materially affect the acetate removal efficiency (all varying between 98.1% and 99.7%). With an increase in influent COD/SO(4)(2-) ratio, both the biofilm thickness and the specific substrate utilization rate decreased slightly but f(SRB) decreased markedly. The estimated results of f(SRB) and f(MB) showed that SRB out-competed MB for bacterial growth if the influent COD/SO(4)(2-) ratio was maintained at less than 1.3, whereas MB out-competed SRB for bacterial growth if the influent COD/SO(4)(2-) ratio was maintained at greater than 2.0. The specific substrate utilization rate of SRB (0.19-0.24mg acetate/mg VSSd) was lower than that of MB (0.31-0.59mg acetate/mg VSSd). The estimated kinetic parameters disclosed that the affinity of acetate to MB was higher and unionized H(2)S imposed a greater inhibiting effect on MB. The model simulation results (acetate and sulfate removal) agreed well with the experimental results.     

Oxygen tolerance in anaerobic pathogenic bacteria

A prerequisite for successful identification of anaerobic pathogenic bacteria from samples of clinical material is the method of cultivation. Currently, several methods of cultivation in anaerobic environment are used: cultivation in anaerobic box, anaerobic jar, and in nonrecurring cultivation system. Here, we determined the suitability of the above methods of cultivation using the estimation of the growth (diameters of colony size) of commonly isolated anaerobic pathogens (Bacteroides fragilis, Clostridium difficile, and Clostridium perfringens). The tested bacterial strains were exposed to atmospheric oxygen for various time periods and then they were cultivated using different anaerobic cultivation systems. Maximum growth differed, depending on the type of cultivation and the strain used. Thus, largest zone diameters, in the majority of measurements, were achieved in the anaerobic box. However, nonrecurring cultivation system seemed better in several cases; this applied to the cultivation of C. perfringens after 15, 30, and 60 min exposure to atmospheric oxygen as well as the cultivation of B. fragilis after 30 and 60 min of oxygen exposure. The cultivation in anaerobic box was the most convenient method for growth of C. difficile. In almost all cases, higher growth was observed in nonrecurring cultivation system than in the system of anaerobic jar. On the other hand, no significant differences were observed among these anaerobic cultivation systems which confirmed their applicability (taking into account some individual features concerning the optimization of cultivations) for identification of pathogenic anaerobes.