Chatterjee B D, Chakraborti C K
Department of Bacteriology and Serology, School of Tropical Medicine, Calcutta.
J Indian Med Assoc. 1995 Sep;93(9):333-5, 339.
The magnitude of non-sparing anaerobic (NSA) infections has been defined in the postoperative wounds on colorectum in children (57.1%), general surgery (0%), abdominoperineal and uterocervical operations (11-45%) in gynaecologic and obstetrical cases and perforative peritonitis (25.8-32.3%). Children below the 6 months age group bear less risk of acquiring NSA infection. Under certain situations, metronidazole combats NSA infections in a better way than other antibacterials. The bacteriology of NSA infections has been probed at the species level in the gynaecologic and obstetrical patients. The species of normal cervix (44.6%) are represented in wounds involving abdominal wall (11%), perineum (22.8%) and uterocervix (45.6%) to suggest endogenous infection. Out of the 22 species of NSA isolated, Peptostreptococcus anaerobius, Acidaminococcus fermentans and Peptococcus prevotii are the commonest. Others were Peptococcus niger, Gaffkya anaerobia, Lactobacillus bulgaricus, Actinomyces bovis, Bacteroides oralis, Fusobacterium gonidiaformans and the different species of peptococcus, peptostreptococcus, eubacterium, propionibacterium and fusobacterium. The weight of evidence indicated a pathogenic role of Peptostreptococcus anaerobius and Ruminococcus flavefaciens, in view of their heavy growth. The umbrella of antibacterials reduced Gram-positive anaerobic cocci from 40% to 16%. The facultative anaerobes Staph aureus, Staph epidermidis, Kl pneumoniae and proteus appeared as the exogenous agents of nosocomial infections.
非选择性厌氧（NSA）感染的发生率在儿童结直肠术后伤口中为57.1%，普通外科手术中为0%，妇产科腹部会阴及子宫颈手术中为11% - 45%，穿孔性腹膜炎中为25.8% - 32.3%。6个月以下的儿童发生NSA感染的风险较低。在某些情况下，甲硝唑对抗NSA感染的效果优于其他抗菌药物。已在妇产科患者中对NSA感染的细菌学进行了菌种水平的探究。正常宫颈的菌种（44.6%）在涉及腹壁（11%）、会阴（22.8%）和子宫颈（45.6%）的伤口中出现，提示内源性感染。在分离出的22种NSA菌种中，厌氧消化链球菌、发酵氨基酸球菌和普氏消化球菌最为常见。其他的有黑色消化球菌、厌氧加夫基菌、保加利亚乳杆菌、牛放线菌、口腔拟杆菌、产子样梭杆菌以及消化球菌、消化链球菌、真杆菌、丙酸杆菌和梭杆菌的不同菌种。大量证据表明，鉴于厌氧消化链球菌和黄化瘤胃球菌生长旺盛，它们具有致病作用。抗菌药物使革兰氏阳性厌氧球菌从40%降至16%。兼性厌氧菌金黄色葡萄球菌、表皮葡萄球菌、肺炎克雷伯菌和变形杆菌成为医院感染的外源性病原菌。
