Clinical aspects of anaerobic infections in the surgical patient.

Oxygen-sensitive anaerobic bacteria comprise the largest group of organisms among the human endogenous microflora. The oral cavity, vagina and colon are the areas where obligate anaerobes are predominant and can be isolated in very high numbers. Sepsis following surgery of any of these organs is frequently due to the escape of endogenous bacteria during the course of the operative procedure. To isolate and successfully identify most of these anaerobic microorganisms from clinical exudate, special collection and bacteriologic techniques are necessary. The acceptable anaerobic collection techniques mentioned above minimize exposure of the clinical specimen to atmospheric oxygen during collection and transfer. Clinical clues indicating anaerobic sepsis include a putrid odor of the exudate and evidence of abscess, necrosis or associated gas formation. The importance and value of the Gram stain in early identification of surgical sepsis is stressed. Treatment of infectious complications includes surgical drainage and specific antibiotics.