Anaerobic bacteremia as observed in a children's hospital. Clinically this may signify true anaerobic sepsis

Abstract

To ascertain the significance of anaerobic bacteremia in a children's hospital, the records of all patients whose blood cultures grew anaerobes during a 24-month period were reviewed. Anaerobes were isolated from 144 out of 1,126 blood cultures yielding bacteria. Anaerobic diphtheroid grew in 122 out of 143 anaerobic cultures, but only 4 out of 122 were isolated from patients with anaerobic sepsis. Nine per cent of the total episodes of anaerobic bacteremia occurred in 13 children who met out criteria for anaerobic sepsis; two oor more blood cultures obtained within a three-day period growing anaerobic bacteria, or an aerobe and an anaerobe, in a febrile child or one with an apparent infectious focus. Bacteroides accounted for 7 out of 13 (64 per cent) of the relevant isolates, while anaerobic diphtheroids 4 out of 13 (26 per cent) and anaerobic gram-positive cocci accounted for the remainder 2 out of 13 (18 per cent). Only one infant, with polymicrobial bacteremia, died, suggesting that anaerobic bacteremia is associated with less mortality in children than in adults. Anaerobic sepsis occurred in children who have had recent abdominal surgery, or who are immunosuppressed.