Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
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The results of early studies showed that anaerobes account for 20% of all bacteremias; more-recent data suggest that these organisms account for approximately 4% (0.5%-9%) of bacteremias ( or approximately one case per 1,000 admissions), with variation by geographic location, hospital patient demographics, and especially, patient age. Elderly persons seem to be at increased risk for developing anaerobic bacteremia while young children (2-5 years of age) are at the least risk. ⋯ Associated risks for mortality include chronic liver disease and congestive heart failure. There is value in performing separate anaerobic blood cultures; clinicians at each institution should determine the prevalence of anaerobic bacteremia and use this information to guide blood-culture practices.
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In previous studies, Bacteroides fragilis group organisms isolated from Korean patients were more frequently resistant to various antimicrobial agents, including clindamycin, than were isolates in other countries. A recent report of increased resistance of Peptostreptococcus species prompted us to include such isolates in a study of antimicrobial susceptibility. anaerobes isolated in 1994 at a tertiary care hospital in Seoul were tested by agar dilution method. None of the B. fragilis group organisms were resistant to imipenem, cefoxitin, chloramphenicol, or metronidazole. ⋯ Peptostreptococcus isolates were susceptible to piperacillin, cefotaxime, and imipenem, while 7.4% were resistant to penicillin G, cefotetan, and metronidazole, and 25.9% were resistant to clindamycin. The isolates resistant to penicillin G, cefotetan, and metronidazole were identified as Peptostreptococcus anaerobius. In conclusion, besides the well-known high rate of resistance of B. fragilis group organisms to clindamycin, the emergence of resistance of Peptostreptococcus species isolates to beta-lactam drugs has become obvious in Korea.