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PubMed1985

Encapsulation and protection against phagocytosis by Bacteroides fragilis.

The capsular polysaccharide of Bacteroides fragilis is most probably an important virulence factor as shown by its ability to protect against phagocytosis in in vitro studies, and by its abscess-promoting ability in experimental in vivo studies. Immunity against the capsular polysaccharide, either in the form of humoral antibodies or as cell-mediated immunity, can facilitate phagocytosis or prevent abscess formation. The capsular polysaccharides in two reference strains examined so far are complex in structure, and seem to be strain specific. The B. fragilis lipopolysaccharide has a relatively low endotoxic activity when compared to lipopolysaccharides from bacteria belonging to Enterobacteriaceae. Structurally the B. fragilis lipopolysaccharide has a relatively low molecular weight, and short polysaccharide chains similar to those found in lipopolysaccharides from rough mutants of Enterobacteriaceae or from capsulated bacteria such as Neisseria meningitidis and Haemophilus influenzae.

Abscess↗
PubMed1985

Concepts of anaerobic infection in relation to prevention and management.

Concepts of anaerobic infection are reviewed in relation to the management of wounds that might be contaminated by facultative or anaerobic organisms or mixtures of these. Considerations of post-operative wound infections oblige us to consider the indications for per-operative antimicrobial prophylaxis and to bear in mind the role of anaerobes and the possibility of pathogenic synergy in these situations. Pathogenic associations of anaerobes with other organisms are further considered in relation to periodontal disease and anaerobic vaginosis. The various roles of anaerobes in enteropathogenic conditions are briefly considered. There is a continuing obligation on clinical bacteriologists and clinicians to work together towards the more effective prevention and management of infections that may or may not have a significant anaerobic component.

Adult↗
PubMed1979

Microbiologic and antibiotic aspects of infections in the oral and maxillofacial region.

An overview of infection as it applies to the oral and maxillofacial region has been provided. The following conclusions are drawn: odontogenic infections are caused by microbes found in the host's oral flora; cultures of purulent material generally will yield three to six anaerobes and one aerobe, (the aerobe is usually a Streptococcus species); Gram stains of purulent material can aid in therapeutic strategies; anaerobic as well as aerobic cultures are necessary to isolate all pathogens; pathogens found in infections of bite wounds reflect the oral flora of the aggressor; early postoperative wound infections are caused by the host's own flora, whereas later infections may be caused by hospital-acquired bacteria; and hepatitis B and herpes simplex virus are occupational hazards. Recommendations have been made for antimicrobial prophylaxis and for treatment. We recognize that some of these selections may be controversial. For instance, the value of prophylactic antibiotics in orthognathic surgery is not well defined; recommendations were made only in certain instances. However, in severe penetrating maxillofacial injuries with devitalized tissue, recommendations for antibiotics were for broad and prolonged coverage. In this instance, use of antibiotics is considered therapeutic and not prophylactic. In each instance, we tried to validate the selection. Our rationale has been to choose the antibiotics most active against the likely pathogens; additionally, consideration was given to drug toxicity and adverse reactions. We regard penicillin as the preferred agent for prophylaxis and treatment of most odontogenic infections. Alternative drugs include cephalosporins, doxycycline, and clindamycin. Erythoromycin and tetracycline are considered less effective than the former agents. Finally, we believe that successful treatment of infection depends as much on changing the microenvironment of the infected tissue by debridement and drainage as on appropriate antimicrobial therapy.

Actinomycosis↗
PubMed1985

The incidence of wound infection after stapled or sutured bowel anastomosis and stapled or sutured skin closure in humans and guinea pigs.

In a study of antimicrobial prophylaxis in colorectal surgery, a higher incidence of wound sepsis was noted in patients who underwent stapled rather than sutured anastomoses and skin closures. There were six wound infections in 69 patients (8.7%) who underwent nonstapled anastomoses compared with seven in 28 (25%) in whom GIA or EEA staplers were used (p = 0.003). Excluding the EEA-stapled cases, the infection rate was 29% (p = 0.022). In patients who underwent sutured anastomoses, there were no wound infections in 21 whose skin was closed with sutures compared with five in 38 patients (13%) with stapled skin closure (p = 0.082). In an experimental guinea pig model dual incisions were infected with Bacteroides fragilis and Escherichia coli. One incision was then closed with staples, the other with sutures. There was a statistically significant (p = 0.016) advantage to the use of staplers. The possible significance of these results is discussed.

Animals↗
PubMed1986

High homology of membrane proteins electrophoretic pattern in Bacteroides fragilis as confirmed by various solubilizing methods.

Membrane proteins from 25 strains of B. fragilis isolated in different laboratories in Northern Italy were examined by SDS-PAGE and isoelectrofocusing. The electrophoretic patterns of inner and outer membrane after Sarkosyl and SDS solubilization of all the isolates were consistently similar to that of the reference strain. The protein profiles of the different species belonging to the B. fragilis group are clearly distinguishable with negligible similarities. Our data clearly show that this approach is extremely helpful and reliable in providing additional verification of the identity of strains recognized by conventional tests. In this connection PAGIF analysis of triton solubilized isolated envelopes reduces technical time and difficulties, thus improving analytical accuracy.

Bacteroides Infections↗
PubMed1985

Air in painful total hip arthroplasty: diagnosis and treatment.

A 78-year-old woman presented with a painful total hip arthroplasty five years postoperation. Plain radiographs revealed air in the hip joint. Aspiration of the hip indicated hip sepsis, and arthrogram showed communication of the hip joint with the sigmoid colon. Cultures grew Bacteroides fragilis. Abdominal exploration showed a ruptured diverticulum that decompressed through the sciatic notch into the total hip arthroplasty. A colostomy was performed, and the hip joint was drained and debrided laterally at the same operation. The prosthesis was later removed with all cement, and the hip was converted to a Girdlestone resection. The authors conclude that air or gas shadows in a painful total hip arthroplasty are an ominous finding and mean either joint sepsis with a gas-forming bacteria or communication of the joint with a hollow viscus and sepsis.

Aged↗
PubMed1985

[Hyperbaric oxygen therapy of anaerobic brain abscesses following tonsillectomy].

This study describes the clinical course of a 31 year old woman who developed multiple anaerobic brain abscesses six days after tonsillectomy, followed by hemoparesis and dysarthria. In spite of craniotomy, repeated punctures and drainage of pus and high dose local and systemic antibiotics, there was an obvious deterioration in the patient's condition. Hyperbaric oxygen therapy was tried as a last resort. The patient improved quickly, and six months after the tonsillectomy seems to be neurologically symptomfree.

Adult↗
PubMed1985

Myocardial infarction complicated by myocardial rupture and Bacteroides sepsis.

A patient in whom a myocardial rupture complicated recent myocardial infarction was found to have cardiac and systemic Bacteroides sepsis; he had just completed a course of steroids. Surgical repair of the cardiac rupture, mediastinal irrigation with povidone-iodine, and broad-spectrum antibiotics resulted in the patient's recovery.

Anti-Bacterial Agents↗
PubMed1985

Experimental Bacteroides fragilis bacteremia in a primate model: evidence that Bacteroides fragilis does not promote the septic shock syndrome.

Experimental Bacteroides fragilis bacteremia was studied in subhuman primates. Following intravenous infusion of viable B. fragilis there was an exponential clearance of organisms from the bloodstream. The major clearance organ was the liver, which accumulated 68.2% of the total inoculum. The most efficient clearance was exhibited by the spleen, with uptake of 1.16% gm tissue. Hemodynamic studies revealed no significant changes in heart rate, mean arterial pressure, or cardiac output following B. fragilis infusion. Complement activity as measured by CH50, alternative pathway hemolytic activity, granulocyte aggregometry, C4, C3, properdin, and Factor B levels were similarly unaffected by infusion of B. fragilis. In contrast, profound hemodynamic changes and a consistent decrease in complement activity was noted after challenge with S. minnesota. The results of this study suggest that B. fragilis bacteremia has a minor role in producing the acute hemodynamic changes associated with the septic shock syndrome.

Animals↗