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Aspirates of serous ear fluids from 57 children were examined for aerobic and anaerobic bacteria. Bacterial growth was noted in 23 patients (40 per cent). Aerobic organisms only were recovered in 13 aspirates (57 per cent of the culture-positive aspirates); anaerobic bacteria in four (17 per cent); and mixed aerobic and anaerobic bacteria in six (26 per cent). A total of 45 bacterial isolates were recovered, accounting for 2.0 isolates per specimen (1.4 aerobes and 0.6 anaerobe). There were a total of 31 aerobic isolates, including Hemophilus influenzae (eight isolates), Staphylococcus aureus and Streptococcus pneumoniae (five of each), and Staphylococcus epidermidis and alpha-hemolytic streptococcus (four of each). Fourteen anaerobes were recovered, including anaerobic gram-positive cocci and Bacteroides melaninogenicus (five isolates each) and Propionibacterium acnes (three isolates).

An improved transport system for samples containing anaerobic bacteria was developed. This system increased the recovery rate of anaerobic bacteria up to 28.8% as compared to a commonly used method.

To assess the causative role of non-sporing anaerobes in cass of erosive balanoposthitis, anaerobic culture was performed on purulent discharges from 104 patients with penile ulceration, a foul-smelling discharge, and a mixed and motile bacterial flora. Most of 29 culturally confirmed infections were due to mixed anaerobes and eight to single anaerobes. A rapid response to treatment with metronidazole also confirmed the anaerobic cause of the infection. Thus, acute anaerobic balanoposthitis can be readily diagnosed clinically and is easily treated.

In a rat model of anaerobic subcutaneous abscess developed to study the pathogenicity of pure cultures of black pigmented Bacteroides sp. (Bacteroides melaninogenicus and Bacteroides intermedius) maximum lesions were seen between 7 and 15 days after inoculation. Abscesses were produced by one type strain each of B. melaninogenicus and B. intermedius and by 20 of 25 clinical isolates of black pigmented Bacteroides species.

Aspiration of the exudate through open perforation was performed in 54 children with chronic suppurative otitis media. Eighty aerobic and 81 anaerobic isolates were recovered. Aerobic bacteria only were involved in 20 patients (37%), and anaerobic organisms only in seven (13%). Mixed aerobic and anaerobic isolates were recovered from 27 patients (50%). The most common bacteria isolated were anaerobic gram-positive cocci, Bacteroides melaninogenicus group, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Staphylococcus aureus. There were 45 beta-lactamase-producing bacteria (BLPB), 30 aerobes, and 15 anaerobes recovered from 38 patients (70%). beta-Lactamase activity was detected in 30 of the 38 ear aspirates (79%) that contained BLPB. All but one of these organisms were in excess of 10(4) colony-forming units/mL. The detection of beta-lactamase activity in the ear aspirates provides evidence of the role of BLPB in the failure of penicillin therapy to eradicate chronic ear infection.

Isolation procedures involving the direct plating of specimens and the use of selective, non-selective, transport and enrichment media were compared in respect of their value for the recovery of Bacteroides melaninogenicus from the gingival sulcus. A selective medium containing kanamycin and vancomycin enhanced the recovery rate of B. melaninogenicus. VMGII transport medium was convenient to use and gave as good a recovery rate as that obtained with plates directly inoculated in the clinic.

The main cause of anaerobic pulmonary infections is aspiration of saliva, upper airway secretions or gastric content. Predisposing conditions include prominent dental disease, chronic upper respiratory tract infections and reduced consciousness. Fusobacterium nucleatum, Bacteroides melaninogenicus and anaerobic Gram-positive cocci are the most frequently encountered organisms. The clinical presentations are lung abscess, lung gangrene and empyema, which all tend to take a slow and indolent course. Preferred localization are dependent lung segments, most often on the right side. For bacteriological examination in these infections, only transtracheal aspirate and aspirate from the lung or pleural space are considered adequate. In 26 cases of empyema treated in our hospital during the last 3 years, adequate specimens had been taken in 19. Fifteen had been adequately examined, and anaerobes were cultured in 6. Among 29 abscesses treated during the same period, adequate specimens had been taken in only 14, and 11 had been properly examined. Seven specimens grew anaerobes on culture. In prospective studies of transtracheal aspirate in 15 chronic bronchitics without emphysema, anaerobes were not demonstrated. In 11 patients with bronchiectasis, anaerobic bacteria were cultured in 3. Finally, no anaerobic bacteria could be demonstrated in the transtracheal aspirate from 76 patients with acute exacerbation of chronic bronchitis. Anaerobic, pulmonary infections do not represent an intriguing medical problem in our region. However, knowledge of these infections is necessary to secure adequacy in collection of specimens and in their bacteriological examination.

Three cases of breast abscess from which the non-sporing anaerobe Bacteroides was isolated are described. This organism has apparently not previously been reported as a cause of abscess in a breast without underlying malignancy.

Gram-negative anaerobic bacilli were isolated on an enriched selective medium from specimens of subgingival plaque from 20 normal, healthy adults without periodontal disease. a heavy growth of Bacteroides and Fusobacterium spp. was obtained from all specimens and 10 representative colonies from each subject were selected for identification by conventional bacteriological methods. Results were obtained in these tests with 188 isolates; some strains of the B. melaninogenicus/oralis group would not grow in pure culture on solid media and showed satellitism in mixed culture, and some strains of fusobacteria did not survive repeated subculture. Most isolates (68%) belonged to the B. melaninogenicus/oralis group. The commonest species identified in this group were B. oralis (41%), B. melaninogenicus ss. melaninogenicus (26%) and ss. intermedius (17%). B. oralis was isolated from all subjects and at least one strain of B. melaninogenicus was isolated from 18 out of 20 subjects. Only eight strains of the B. fragilis group were detected and they probably represented transient carriage. Fusobacterium spp. and L. buccalis were isolated from 15 out of 20 subjects and accounted for 21% of the isolates studied, but most could not be identified specifically by the set of tests used. Asaccharolytic species of Bacteroides were isolated in small numbers from seven subjects.

During a 3 1/2 year period anaerobic septic arthritis was diagnosed in 43 patients (46 joints). The hip and knee accounted for 83% of the infected joints. Anaerobic infections complicated elective musculoskeletal surgery in 23 patients, including 21 with total joint arthroplasties. An additional 12 patients developed septic arthritis following surgical treatment of traumatic injuries of an extremity. Gram-positive cocci were the anaerobes most commonly found in these two groups of surgical patients, accounting for 64% of the isolates; Peptococcus magnus was the most common organism. In contrast, gram-negative bacilli (especially Bacteroides fragilis) comprised 63% of the anaerobes isolated from eight patients with chronic debilitating diseases who had not had prior surgery. Only anaerobes were recovered from approximately half of all the patients with septic arthritis while mixed aerobic-anaerobic cultures accounted for the remainder. Adequate treatment required aggressive surgery and prolonged (minimum of three weeks) antimicrobial therapy. Infected total joint arthroplasties had to be removed. Loss of joint function occurred in six patients with posttraumatic infections when surgery was delayed or antimicrobials were inadequate. Outcome was poorest in the patients with chronic debilitating diseases, four of whom died.

A qualitative and quantitative bacteriological study was performed on pus specimens obtained by needle aspiration of 50 acute dento-alveolar abscesses. Most samples contained a mixture of species (average 3.3); 20 (40%) of the abscesses contained anaerobes alone, 3 (6%) contained facultative anaerobes only and the remaining 27 (54%) contained mixtures of both types of bacteria, with anaerobes predominating. In total, 166 bacterial strains were isolated, 75% of which were strictly anaerobic; the most common species were Peptococcus spp, Bacteroides oralis and B. melaninogenicus. Among facultative anaerobes, Streptococcus milleri was particularly common. The mean concentration of bacteria in each abscess was 10(6.9 +/- 0.2). The mean concentration of anaerobic bacteria was 10(6.2 +/- 0.1) and of facultatively anaerobic bacteria 10(5.7 +/- 0.2).

Bacteriologic cultures of the vagina and the cervix of 38 praepubertal children, aged 3 months to 16 years (average age 9 years) from the outpatient department for infants and juveniles of the 1st Department of Obstetrics and Gynecology of the University of Vienna were obtained vaginascopically using anaerobic transportmedia (Port a Cul) and were examined for aerobic and anaerobic bacteria. An average of 5.3 species was also isolated per child (2.9 aerobic and 2.5 anaerobic species). The commonest anaerobes were Peptococcus, Peptostreptococcus, Bact. melaninogenicus, Proprionibacterium and Veillonella parvula, the prevalent aerobes, were Enterococci, E coli and Staphylococcus epidermidis. Our results suggest that anaerobic bacteria amount a significant component of the flora of the lower genital-tract of healthy children, as well as of infants with vaginal discharge.

Fluoretec, a commercial kit for the rapid diagnosis by immunofluorescence of infections caused by Bacteroides spp was compared with a standard culture method. A total of 1010 specimens were tested for the presence of B fragilis group by Fluoretec F and B melaninogenicus-oralis and asaccharolytic groups by Fluoretec M. Fluoretec F was positive in 123/152 specimens culturing B fragilis group strains. Seventeen specimens were positive by Fluoretec F but negative on culture. Fluoretec M was positive in 21 of 22 specimens from which B melaninogenicus was cultured. The Fluoretec system was convenient in use, results being obtained within one hour of receipt of the specimen.

The canal contents of thirty-three cariously and traumatically exposed pulpless teeth were sampled with a special technique and cultured anaerobically for growth in prereduced thioglycollate and for Bacteroides melaninogenicus on selective blood agar plates. The presence of B. melaninogenicus was compared with the presence or absence of eight symptoms associated with pulpal necrosis and the presence or absence of growth in thioglycollate. B. melaninogenicus was found to be significantly related to pain, sinus tract formation and foul odor. Suggested relationships were found between the organism and the presence of apical sensitivity and local swelling. Growth in prereduced thioglycollate occurred more often from teeth in which B. melaninogenicus was present. With the sampling technique used, positive growth in the thioiglycollte ranged from 88 percent at the initial appointment to 72 percent at the fill appointment.

Bacteroides intermedius includes two distinct groups of organisms that are phenotypically indistinguishable by conventional methods. These two groups are represented by the type strain of the species ATCC 25611T (B. intermedius type I) and by ATCC 33563 (B. intermedius type II). Members of each group can be distinguished from each other by analysis of the cellular protein composition by SDS-polyacrylamide gel electrophoresis (SDS-PAGE) and by DNA-DNA homology studies, because they share less than 40% homology. The purpose of this study was to prepare specific DNA probes for the two groups of Bacteroides intermedius and to test them against field isolates. Whole-cell DNA probes were prepared from B. intermedius types I and II and tested against 253 field strains of Bacteroides which had been identified by conventional phenotypic tests as B. intermedius. Of these, 170 (67%) hybridized with the B. intermedius type I DNA probe, 28 (11%) with the type II, and 23 (9%) failed to react with the B. intermedius probes but did hybridize with either B. melaninogenicus, B. loescheii, or B. corporis whole-cell DNA probes. The 32 (13%) remaining isolates failed to hybridize with any of the five Bacteroides probes or with probes to B. asaccharolyticus, B. buccae, B. buccalis, B. denticola, B. gingivalis, B. oralis, or B. oris. These data demonstrate the usefulness of whole-cell DNA probes for the identification of phenotypically similar or identical field isolates.

The bacterial flora of the preputial space of 210 healthy males (43 children aged between 2 and 11 years, 137 males between 12 and 60 years and 30 men over 60 years) was determined by smears and cultueres from glans penis, sulcus coronarius and the adjacent prepuce. The results were grouped according to various criteria, e.g. glans covered or uncovered and age of males. Differences in the distribution of germs could be found in relationship to age. In the case of an uncovered glans penis the presence of microbial flora corresponds to the grampositive saprophytic bacteria in areas rich in sebaceous glands. In the case of a covered glans the density of microorganisms increases. Prevalent are gramnegative anaerobes, especially Bacterioides melaninogenicus, also enterococci, enterobacteria and coagulase-positive staphylococci.

Tympanocentesis was performed in 32 pediatric patients with chronic recurrent suppurative otitis media. The aspirate was cultured aerobically and anaerobically. Aerobes were isolated from ten patients (31.2%); anaerobes from one patient; and both aerobes and anaerobes from 21 patients (65.6%). There were 46 aerobic isolates. The aerobes commonly recovered were Pseudomonas aeruginosa (24 isolates) Proteus sp. (5) and Staphylococcus aureus (3). There were 32 anaerobes isolated including anaerobic gram-positive cocci (19 isolates) and Bacteroides sp., the latter of which included Bacteroides fragilis group and Bacteroides melaninogenicus (9). The patients were treated by parenteral carbenicillin 300 to 400 mg per kg per day given in four dosages administered for a period of 12 to 21 days (average 17 days). An aminoglycoside (gentamicin) was added in 15 patients. The clinical response was good in 17 patients and poor in 15. There were no side effects or adverse reactions noted during therapy. The above findings demonstrate the polymicrobial etiology of chronic recurrent suppurative otitis media and suggest that treatment directed against the aerobic and anaerobic isolates is efficacious in more than half of the cases.

The bacterial flora of the genital tracts of twenty-two patients with septic abortion and twenty normal women (as controls) were studied to determine the significant aetiological agents. The predominant flora qualitatively and quantitatively in the twenty-two patients were anaerobes. Bacteroides bivius was isolated from all the twenty-two patients and from twelve out of twenty normal controls. The next commonest anaerobes were B. asaccharolyticus (fourteen out of twenty-two patients), B. melaninogenicus (ten out of twenty-two), B. fragilis (eleven out of twenty-two), B. disiens (eight out of twenty-two) and anaerobic cocci (six out of twenty-two); they were also isolated from nine out of twenty, twelve, zero, eight and three control subjects respectively. The commonest facultative bacteria isolated from both the patients and afebrile controls were Escherichia coli, Klebsiella aerogenes and Streptococcus faecalis. The comparative increase in number of patients colonized by the anaerobes and the increase in the bacteria, by quantitative assessment in the patient group, signify the importance of anaerobes in septic abortion.

Leg ulcers in 26 patients with sickle-cell disease (SCD) were studied bacteriologically over a period of 6 months. The average age of the patients was 20.92 years and the mean duration of the ulcers was 3.43 years. In order of frequency, Staphylococcus aureus, Pseudomonas aeruginosa, and Bacteroides melaninogenicus were the predominant organisms. Anaerobes were isolated from 14 (54%) of 26 patients and represent 21% of the total 77 isolates. The presence of anaerobes correlated well with odorous ulcers. Isolation of anaerobes from leg ulcers of patients with SCD has added to knowledge of bacterial infection in SCD.

The vaginal secretions of 20 normal control subjects and 21 patients with motile, curved anaerobic rods were cultured for aerobic and anaerobic bacteria, Chlamydia trachomatis, herpes simplex virus, and Trichomonas vaginalis. Extensive histories and physical examinations of the patients and microscopic appearance and gas-liquid chromatography patterns of vaginal secretions were compared between the two groups. The patients who had motile rods in their vaginal secretions more frequently presented with a history of complaints about foul-smelling discharge (18 [86%] of 21); discharge noted during physical examination at their introitus (15 [71%] of 21); a vaginal pH greater than 4.5 (21 [100%] of 21); and a highly specific microscopic appearance of their secretions. The secretions were characterized by the absence of lactobacilli, the presence of highly motile, curved bacilli, and an increased number of background bacteria when compared with normal patients. Patients had more frequent anaerobic isolates than did controls (P less than .001), with increased numbers of Peptococcus, Peptostreptococcus, Propionibacterium, and Bacteroides species. All patients with motile bacteria in their secretions met the criteria of the syndrome of nonspecific vaginosis that has been previously described.

Prevalence of anaerobic bacterial infection in 120 sputum positive cases of pleuro-pulmonary tuberculosis was found to be 53.3 per cent-either as pure or mixed with aerobes. Bacteroides fragilis and B. Melaninogenicus were isolated in 19 (26.6%) and 12 (18.72%) cases respectively. Sensitivity studies showed that these were most sensitive to metronidazole followed by rifampicin and kanamycin. The possibility of anaerobic infection may be considered in patients of pulmonary tuberculosis who do not respond to routine treatment.

The roll tube culture technique was utilized to examine quantitatively and qualitatively the predominant cultivable microflora inhabiting the clinically healthy gingival sulcus. Seven periodontists aged 32-54 years were included in the study. From a total of 350 isolates, 85 (24.3%) were obligate anaerobes, 53 (15.0%) were Gram negative, and 197 (56.3%) were categorized as rods. Actinomycetes predominated in three samples. Four samples were dominated by Streptococcus species. The flora as revealed in the present study comprised a markedly lower proportion of Gram-negative organisms than that found at the base of deep periodontal pockets.

Bacteroides fragilis group and Bacteroides melaninogenicus group fluorescent-antibody kits were evaluated with 188 clinical specimens and 116 fresh aerobic and anaerobic bacterial isolates. Fluorescent-antibody and culture results corresponded in 88% of clinical specimens of the B. fragilis group and 94% of clinical specimens of the B. melaninogenicus group. There was greater than or equal to 90% correlation for both kits with colony smears. Antigen sharing by Bacteroides bivius, Bacteroides disiens, and B. melaninogenicus was demonstrated.