Diagnosis of anaerobic infection by gas chromatographic estimation of volatile fatty acids.

Nine hundred and eighty-one fluid specimens were analysed by culture and by gas chromatography. The presence of obligate anaerobes was best predicted if one or more of the volatile acids isobutyric, butyric, isovaleric, valeric, isocaproic or caproic acid were detected in the specimen. Propionic acid was not a good indicator of the presence of obligate anaerobes. The agreement between gas chromatography and culture for obligate anaerobes in the main study (841 specimens, 232 culture positive) was: co-positivity 82%; co-negativity 92%. Falsely negative specimens contained anaerobes which had probably not produced sufficient of their characteristic volatile fatty acids to be detected. When it was the sole infecting anaerobe, Bacteroides fragilis seemed especially likely to be missed by gas chromatography. Forty-five of the 51 falsely positive specimens probably represented failure to culture anaerobes rather than spurious volatile fatty acid detection.