Significant decrease of gram-negative anaerobic bacteremia in a major hospital from 1967-73 to 1981-89: an effect of the introduction of metronidazole?
Declining rates of anaerobic bacteremia are reported from medical centres all over the world. At Odense University Hospital the frequency of Gram-negative anaerobic bacteremia decreased from 1.62% in 1967-73 to 0.83% in 1981-89 (p < 0.001). Metronidazole prophylaxis prior to bowel surgery seems to be the most important explanation, as the association of Bacteroides bacteremia with surgery decreased from 80% to 48% (p < 0.01) and no cases of Bacteroides bacteremia occurred during metronidazole treatment without the presence of abscess or gangrene. A contributory factor may be improved methods for abscess localization and drainage. Other drugs having an effect on anaerobes seem of minor importance. A new category of patients seems to be those who have undergone aorto-femoral bypass operation for aneurysm of the aorta. They contract anaerobic Gram-negative bacteremia from infected hematomas or intestinal gangrene.
Siboni
A
A
Department of Clinical Microbiology, Odense University Hospital, Denmark.
Graversen
K
K
Olsen
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006089:Gram-Negative Anaerobic Bacteria / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D006785:Hospitals, University; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D011292:Premedication
D008795:Metronidazole