Korean J Intern Med.  2009 Mar;24(1):13-18. 10.3904/kjim.2009.24.1.13.

Clinical Features and Prognostic Factors of Anaerobic Infections: A 7-Year Retrospective Study

• Park Y
• Choi JY
• Yong D
• Lee K
• Kim JM

• KMID: 1785636
• DOI: http://doi.org/10.3904/kjim.2009.24.1.13

Abstract

BACKGROUND/AIMS: Risk factors for mortality resulting from anaerobic infection are incompletely defined. The clinical significance of a broad range of pathogenic obligate anaerobic organisms was examined, and factors independently associated with mortality were identified in patients with clinically significant anaerobic infections. METHODS: The medical records of 1,050 patients with anaerobic infections were retrospectively reviewed at Severance Hospital in Seoul, Korea. RESULTS: The mean age of the patients was 54.1+/-16.8 years, and 57.7% were men. Overall, 320 (30.5%) patients with case-defined illness experienced pain at the affected site, and 230 (21.9%) experienced pus flow from lesions. Ten (1.4%) patients presented with shock, and 80.3% of the clinically significant cases were polymicrobial anaerobic infections. The mean number of pathogens, including aerobic and anaerobic bacteria, was 3.7+/-1.0 (minimum 1, maximum 5), and the number of anaerobic organisms was 1.0+/-0.3 in each specimen. The major pathogens by rank were the Bacteroides fragilis group, which accounted for 41.8% of anaerobic infections, followed by Clostridium spp. (11.8%), Prevotella spp. (9.4%), and Peptostreptococcus spp. (8.4%). Escherichia coli (17.5%), Staphylococcus aureus (7.5%), and Klebsiella pneumoniae (7.5%) were common concomitant aerobic organisms. The overall crude mortality rate resulting from anaerobic infection was 29.7%. Among the determining factors associated with mortality, liver disease (p=0.003) and old age (p=0.005) were significant in multivariate analysis. CONCLUSIONS: Anaerobic infection is polymicrobial and has a significant role in morbidity and mortality. Underlying liver disease was associated with poor prognosis in anaerobic infection.

Keyword

Anaerobic bacteria; Prognosis

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents/*therapeutic use
Bacteria, Anaerobic/*isolation & purification
Bacterial Infections/*epidemiology/microbiology/therapy
Drainage/methods
Female
Follow-Up Studies
Humans
Korea/epidemiology
Male
Middle Aged
Morbidity/trends
Prognosis
Retrospective Studies
Survival Rate/trends
Time Factors
Young Adult