Community-acquired anaerobic bacteremia in adults: one-year experience in a medical center
Min-Nan Hung, Shey-Ying Chen, Jiun-Ling Wang, Shan-Chwen Chang, Po-Ren Hsueh, Chun-Hsing Liao, Yee-Chun Chen
Departments of Internal Medicine and Emergency Medicine, National Taiwan University Hospital, Taipei; Department of Medicine and Graduate Institute of Clinical Pharmaceutical Science, National Taiwan University College of Medicine, Taipei; and Department Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
Received: May 20, 2005 Revised: August 12, 2005 Accepted: August 19, 2005
A prospective observational study was conducted to evaluate the clinical characteristics and outcome of community-acquired anaerobic bacteremia. From June 1 2001 through May 31 2002, 52 patients with community-acquired anaerobic bacteremia were enrolled at the emergency department in a teaching hospital. There were 19 patients (34%) with polymicrobial bacteremia and Escherichia coli was the most common copathogen (n = 6). Of 62 anaerobic isolates, species of the Bacteroides fragilis group were the most common isolates (n = 28, 45%), followed by Clostridium spp. (n = 11, 18%). Among the 52 patients enrolled, up to 27% had underlying malignancy and the gastrointestinal tract accounted for 48% of the sources of infection. Clinical manifestations suggesting anaerobic infections were common and three-quarters (n = 39) of 52 patients received adequate empirical antimicrobial treatment. Documentation of anaerobic bacteremia seldom influenced antimicrobial treatment. The 30-day mortality was 25%. Although univariate analysis revealed that underlying malignancy (p=0.003), leukopenia (p=0.044) and absence of fever (p=0.047) were associated with mortality, only malignancy (p=0.007) was an independent risk factor in the multivariate analysis.
Anaerobic bacteremia, community-acquired infections, mortality, neoplasms
J Microbiol Immunol Infect 2005;38:436-443.