The bacteria typically described from biliary tract infection include Escherichia coli, Klebsiella, Enterobacter, and enterococci. It has also been r… - Sydney M. Finegold
" "The bacteria typically described from biliary tract infection include Escherichia coli, Klebsiella, Enterobacter, and enterococci. It has also been recognized for some time that Clostridium perfringens may occasionally be involved in serious complications of biliary tract infection such as sepsis and emphysematous cholecystitis. Other anaerobes, including various Bacteroides and Fusobacterium sp, clostridia other than C perfringens, anaerobic cocci and streptococci, and Actinomyces have been reported from a variety of biliary tract infections, usually as single case reports ... More recently, several reports indicate that anaerobes, and especially B fragilis, may be more common in biliary tract infections than had been appreciated ... Anaerobes have been recovered in approximately 40% of such infections; B fragilis is the most common anaerobe encountered. Anaerobes may also be found, as aerobes are, in asymptomatic bactibilia.
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About Sydney M. Finegold
Sydney "Sid" Martin Finegold (August 21, 1921 – September 17, 2018) was an American physician, medical school professor, and researcher in infectious diseases caused by anaerobic bacteria. He was elected in 1971 a Fellow of the American Academy for the Advancement of Science.
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Sydney Martin Finegold
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Anaerobes are prevalent on all mucosal surfaces and virtually all anaerobic infections are endogenous. Two thirds of anaerobic infections involve five anaerobic organisms or groups—the Bacteroides fragilis group, the Bacteroides melaninogenicus-Bacteroides asaccharolyticus group, Fusobacterium nucleatum, the anaerobic cocci, and Clostridium perfringens. Conditions that lower the oxidation-reduction potential and disrupt the mucosal surface (eg, vascular problems, malignant neoplasms, and surgery) lead to infection with anaerobes. Clues to anaerobic infection include foul odor, gas, tissue destruction, underlying malignant neoplasms, and the unique appearance of certain anaerobes on Gram's stain. Specimens must be collected to avoid normal flora and transported to the laboratory under anaerobic conditions. Therapy involves surgical débridement and drainage and the use of various antimicrobial agents. Antimicrobial agents must be used for extended periods to avoid relapse.
... (1) What is the clinical relevance of anaerobic bacteriology? (2) How can the microbiologist, with limited and decreasing resources, perform reliable, detailed studies of anaerobic bacteriology? (3) When and how should susceptibility testing be done with anaerobes? If the clinician knows the usual bacteriology of various types of infection and how this may be modified by pathophysiologic processes in the host or by prior therapy, he/she can use a logical empiric approach to treatment of the patient. As to the microbiologist's dilemma, it is not realistic or rational for a microbiologist in a nonteaching hospital to do detailed bacteriologic studies and routine anaerobic susceptibility testing. The resources available should be committed primarily to the patient who is seriously ill. Such allocation of resources, of course, requires repeated and effective communication between microbiologist and clinician.
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