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بسم الله الرحمن الرحيم
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.
• Gram+ve 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 > clostridia)Infections in damaged and necrotic tissues, or in the immunocompromised.
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Some clinical signs and indicators of non-clostridialanaerobic infections-------------------------------------------------------------------
Foul-smelling pus, discharge or lesionProduction of a large amount of pus (abscess formation) Proximal of lesion to mucosal surface or portal of entryFailure to isolate organism from pus (sterile pus)Infection associated with necrotic tissueDeep abscessGas formation in tissuesFailure to respond to conventional antimicrobial therapyPus which shows red fluorescence under UV lightDetection of “sulphur granules” in pus (actinomycosis)Infection of human or animal wound biteGram-negative bacteraemiaSeptic 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 Gram+ve 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
• “Vincent’s gingivitis”
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Bacteroides species and Related Gram —ve rods. 3 Groups:Saccharolytic group >> 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 fromwhich Anaerobic Gram+ve Cocci are Isolated-------------------------------------------------------------------
Blood culturesCentral nervous system (including brain abscesses)Head and neck infections (including ear)Dental abscesses and infected root canalPeriodontal diseasesHuman and animal bitesPleural infectionsAbdominal infectionsGenito-urinary tract infectionsDecubitus ulcersFoot ulcersOsteomyelitis
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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 tractsPropionibacteriumBifidobacteriumLactobacillusActinomycesEubacterium
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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 mouthMixed 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 examinationCultured on proper media and under anaerobic conditionsGas-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