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KMID : 0338420090240010013
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The Korean Journal of Internal Medicine
2009 Volume.24 No. 1 p.13 ~ p.18
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Clinical Features and Prognostic Factors of Anaerobic Infections: A 7-Year Retrospective Study
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Park Yoon-Sun
Choi Jun-Yong
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Abstract
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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.
Conclusion:Anaerobic infection is polymicrobial and has a significant role in morbidity and mortality. Underlying liver disease was associated with poor prognosis in anaerobic infection.
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KEYWORD
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Anaerobic bacteria, Prognosis
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