Infect Chemother.  2009 Aug;41(4):216-223. 10.3947/ic.2009.41.4.216.

Recent Trends of Anaerobic Bacteria Isolated from Clinical Specimens and Clinical Characteristics of Anaerobic Bacteremia

  • 1Department of Laboratory Medicine and Research Institute of Bacterial Resistance, College of Medicine, Yonsei University, Seoul, Korea.
  • 2Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea.


Anaerobic bacteria can cause various infections, and their incidence may differ greatly, depending on the country or hospital. We investigated recent trends in anaerobe isolation and clinical characteristics of anaerobic bacteremia in one hospital in Korea to facilitate diagnosis and treatment of anaerobic infections. MATERIALS AND METHODS: Anaerobic bacteria isolated from blood, body fluids and abscess specimens at a university hospital in Korea during 2007 and 2008 were analyzed. The medical records of 82 anaerobic bacteremia patients were reviewed. A retrospective cohort study was conducted to determine the risk factors for in-hospital mortality of patients with anaerobic bacteremia. RESULTS: A total of 289 non-duplicated anaerobic isolates were recovered from blood, body fluids and abscess specimens. Bacteroides fragilis (73 isolates, 25.3%) was the most common organism followed by Clostridium perfringens (22 isolates, 7.6%), Peptoniphilus asaccharolyticus (21 isolates, 7.3%) and Anaerococcus prevotii (19 isolates, 6.6%). Eighty-four isolates were recovered from blood specimens, among which B. fragilis (24 isolates) and C. perfringens (21 isolates) were the most frequently isolated organisms. Among the 196 underlying diseases of anaerobic bacteremia patients, neoplastic, infectious, and gastrointestinal diseases accounted for 54 (27.6%), 46 (23.5%), and 41 (20.9%) cases, respectively. The alimentary tract was the most common suspected portal of entry. The in-hospital mortality rate of anaerobic bacteremia patients was 34.2%, and neutropenia at the time of blood culture was the only statistically significant factor associated with mortality in this study. Anaerobes were isolated in 1.4% of all positive blood cultures. CONCLUSIONS: B. fragilis and C. perfringens are expected to be commonly isolated from clinical specimens. Despite its low prevalence, anaerobic bacteremia displays a significant in-hospital mortality rate. Ongoing investigations into anaerobic bacteremia are necessary because of ambiguous risk factors for mortality.


Anaerobe; Bacteremia; Bacteroides fragilis; Clostridium perfringens

MeSH Terms

Bacteria, Anaerobic
Bacteroides fragilis
Body Fluids
Clostridium perfringens
Cohort Studies
Gastrointestinal Diseases
Hospital Mortality
Medical Records
Retrospective Studies
Risk Factors

Cited by  7 articles

Bacteroides faecis and Bacteroides intestinalis Recovered from Clinical Specimens of Human Intestinal Origin
Yangsoon Lee, Hyun Soo Kim, Dongeun Yong, Seok Hoon Jeong, Kyungwon Lee, Yunsop Chong
Yonsei Med J. 2015;56(1):292-294.    doi: 10.3349/ymj.2015.56.1.292.

A Case of Clostridium bifermentans Bacteremia in a Patient with Myelodysplastic Syndrome
Jin A Lee, Hee Jung Yoon, Ji Myung Kim, Seong Min Jo, Yong Hun Choi, Hyun Jin Moon, Ki Ho Yun, Hyeong Kug Kim, Seong Eun Yang
Infect Chemother. 2011;43(5):412-415.    doi: 10.3947/ic.2011.43.5.412.

Changes in Antimicrobial Susceptibility of Blood Isolates in a University Hospital in South Korea, 1998-2010
Nak-Hyun Kim, Jeong-Hwan Hwang, Kyoung-Ho Song, Pyoeng Gyun Choe, Wan Beom Park, Eu Suk Kim, Sang-Won Park, Hong Bin Kim, Nam Joong Kim, Myoung-don Oh, Eui-Chong Kim
Infect Chemother. 2012;44(4):275-281.    doi: 10.3947/ic.2012.44.4.275.

A Fatal Spontaneous Gas Gangrene due to Clostridium perfringens during Neutropenia of Allogeneic Stem Cell Transplantation: Case Report and Literature Review
Hae-Lim Lee, Sung-Yeon Cho, Dong-Gun Lee, Yumi Ko, Ji In Hyun, Bo Kyoung Kim, Jae Hyun Seo, Jung Woo Lee, Seok Lee
Infect Chemother. 2014;46(3):199-203.    doi: 10.3947/ic.2014.46.3.199.

Anaerobic Bacteremia: Impact of Inappropriate Therapy on Mortality
Jieun Kim, Yangsoon Lee, Yongjung Park, Myungsook Kim, Jun Yong Choi, Dongeun Yong, Seok Hoon Jeong, Kyungwon Lee
Infect Chemother. 2016;48(2):91-98.    doi: 10.3947/ic.2016.48.2.91.

Comparison of the Vitek 2, API 20A, and 16s rRNA Gene Sequencing for the Identification of Anaerobic Bacteria
Gyun Cheol Park, Sook Jin Jang, Min Jung Lee, Joong-Ki Kook, Min Jung Kim, Young Sook Kim, Nam Woong Yang, Hye Soo Lee, Seong Ho Kang, Geon Park, Dae Soo Moon
Ann Clin Microbiol. 2015;18(1):20-26.    doi: 10.5145/ACM.2015.18.1.20.

Clostridium symbiosum Isolated from Blood
Hee Jae Huh, Seung Tae Lee, Jang Ho Lee, Chang Seok Ki, Nam Yong Lee
Korean J Clin Microbiol. 2010;13(2):90-92.    doi: 10.5145/KJCM.2010.13.2.90.


1. Finegold SM. Host factors predisposing to anaerobic infections. FEMS Immunol Med Microbiol. 1993. 6:159–163.
2. Bishara J, Wattad M, Leibovici L, Samra Z, Lev B, Abramson E, Paul M. Predictors for anaerobic bacteraemia beyond the source of infection: retrospective, nested, case-control study. Scand J Infect Dis. 2009. 41:33–36.
3. Lombardi DP, Engleberg NC. Anaerobic bacteremia: incidence, patient characteristics, and clinical significance. Am J Med. 1992. 92:53–60.
4. Goldstein EJ. Anaerobic bacteremia. Clin Infect Dis. 1996. 23:Suppl 1. S97–S101.
5. Arzese A, Trevisan R, Menozzi MG. The Italian Anaerobe Study Group. Anaerobe-induced bacteremia in Italy: a nationwide survey. Clin Infect Dis. 1995. 20:Suppl 2. 230–232.
6. Gómez J, Baños V, Ruiz J, Herrero F, Pérez M, Pretel L, Canteras M, Valdés M. Clinical significance of anaerobic bacteremias in a general hospital. A prospective study from 1988 to 1992. Clin Investig. 1993. 71:595–599.
7. Peraino VA, Cross SA, Goldstein EJ. Incidence and clinical significance of anaerobic bacteremia in a community hospital. Clin Infect Dis. 1993. 16:Suppl 4. 288–291.
8. Cockerill FR 3rd, Hughes JG, Vetter EA, Mueller RA, Weaver AL, Ilstrup DM, Rosenblatt JE, Wilson WR. Analysis of 281,797 consecutive blood cultures performed over an eight-year period: trends in microorganisms isolated and the value of anaerobic culture of blood. Clin Infect Dis. 1997. 24:403–418.
9. Lassmann B, Gustafson DR, Wood CM, Rosenblatt JE. Reemergence of anaerobic bacteremia. Clin Infect Dis. 2007. 44:895–900.
10. Fenner L, Widmer AF, Straub C, Frei R. Is the incidence of anaerobic bacteremia decreasing? Analysis of 114,000 blood cultures over a ten-year period. J Clin Microbiol. 2008. 46:2432–2434.
11. Robert R, Deraignac A, Le Moal G, Ragot S, Grollier G. Prognostic factors and impact of antibiotherapy in 117 cases of anaerobic bacteraemia. Eur J Clin Microbiol Infect Dis. 2008. 27:671–678.
12. Blairon L, De Gheldre Y, Delaere B, Sonet A, Bosly A, Glupczynski Y. A 62-month retrospective epidemiological survey of anaerobic bacteraemia in a university hospital. Clin Microbiol Infect. 2006. 12:527–532.
13. Cheon SH, Kim JM, Kim E, Hong CS. Clinical analysis of bacteremia due to anaerobic organisms. Korean J Infect Dis. 1989. 21:87–94.
14. Yoon JY, Choo EJ, Choi SH, Kim MN, Kim NJ, Kim YS, Woo JH, Ryu JS, Chang MS. Clinical characteristics and outcome of invasive Prevotella infection. Korean J Med. 2003. 64:254–259.
15. Shin HJ, Kim MS, Lee K, Chong Y. Trends of Anaerobic Bacteria Isolated from Clinical Specimens. Korean J Clin Pathol. 1999. 19:70–77.
16. Jousimies-Somer HR, Summanen P, Citron DM, Baron EJ, Wexler HM, Finegold SM. Wadsworth-KTL anaerobic bacteriology manual. 2002. 6th ed. Belmont: Star Publishing Company.
17. Brook I, Frazier EH. Infections caused by Propionibacterium species. Rev Infect Dis. 1991. 13:819–822.
18. Clinical and Laboratory Standards Institute. Principles and Procedures for Blood Cultures. Approved Guideline M47-A. 2007. Wayne, Pensylvania: Clinical and Laboratory Standards Institute;36.
19. Wilson JR, Limaye AP. Risk factors for mortality in patients with anaerobic bacteremia. Eur J Clin Microbiol Infect Dis. 2004. 23:310–316.
20. Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control. 1988. 16:128–140.
21. Kiani D, Quinn EL, Burch KH, Madhavan T, Saravolatz LD, Neblett TR. The increasing importance of polymicrobial bacteremia. JAMA. 1979. 242:1044–1047.
22. Wexler HM. Bacteroides: the good, the bad, and the nitty-gritty. Clin Microbiol Rev. 2007. 20:593–621.
23. Murray PR, Baron EJ, Jorgensen JH, Landry ML, Pfaller MA. Manual of Clinical Microbiology. 2007. 9th ed. Washington DC: ASM Press;377.
24. Lee KW, Chong YS, Park QE, Kim MS, Kwon OH. The effect of primary culture media on the isolation of anaerobic bacteria. J Lab Med Qual Assur. 1994. 16:111–116.
25. Chung HK, Chong Y, Lee SY. Effect of brain heart infusion supplementation to Phenylethanol agar on the growth of anaerobic bacteria. Korean J Clin Pathol. 1983. 3:51–59.
26. Bengualid V, Singh H, Singh V, Berger J. An increase in the incidence of anaerobic bacteremia: true for tertiary care referral centers but not for community hospitals? Clin Infect Dis. 2008. 46:323–324.
27. Kim HO, Kang CG, Chong Y, Lee SY. Organisms isolated from blood at the Yonsei medical center, 1974-1983. Korean J Infect Dis. 1985. 17:15–32.
28. Kim HK, Lee K, Chong Y, Kwon OH, Kim JM, Kim DS. Blood culture results at the Severance hospital during 1984-1993. Korean J Infect Dis. 1996. 28:151–165.
29. Koh EM, Lee SG, Kim CK, Kim M, Yong D, Lee K, Kim JM, Kim DS, Chong Y. Microorganisms Isolated from Blood Cultures and Their Antimicrobial Susceptibility Patterns At a University Hospital During 1994-2003. Korean J Lab Med. 2007. 27:265–275.
30. Zahar JR, Farhat H, Chachaty E, Meshaka P, Antoun S, Nitenberg G. Incidence and clinical significance of anaerobic bacteraemia in cancer patients: a 6-year retrospective study. Clin Microbiol Infect. 2005. 11:724–729.
31. Claros MC, Claros ZC, Hecht DW, Citron DM, Goldstein EJ, Silva J Jr, Tang-Feldman Y, Rodloff AC. Characterization of the Bacteroides fragilis pathogenicity island in human blood culture isolates. Anaerobe. 2006. 12:17–22.
32. Muttaiyah S, Paviour S, Buckwell L, Roberts SA. Anaerobic bacteraemia in patients admitted to Auckland City Hospital: its clinical significance. N Z Med J. 2007. 120:U2809.
33. Fry DE. Preventive systemic antibiotics in colorectal surgery. Surg Infect (Larchmt). 2008. 9:547–552.
Full Text Links
  • IC
export Copy
  • Twitter
  • Facebook
Similar articles
Copyright © 2023 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: