MICROBIOLOGY

CASE 1 BACTERIAL WOUND INFECTIONS

BY NIMMAGADDA KETHANA
SECTION B2
GROUP 3
 Bacteriodes are the gram negative , obligate anaerobic bacteria

Bacteriodes species are most important in causing human infection.

Many species in this genus bacteriodes are reclassified into genus Prevotella and
Porphyromonas

They are large in group, these are bile resistant, non spore forming, slender gram negative
rods.

The species retained in the Bacteroides are members of B.fragilis group

BACTEROIDE FRAGILIS
ORGANISM OF INTEREST
BACTERIODES

 MORPHOLOGY
SHAPE: PLEOMORPHIC
SIZE:(0.5-1.5)um WIDE (2-6)um LENGTH.
DISTUGISHING APPERANCE: may appear as coccobacilli.
 GROWTH REQUIRMENT
In a less oxygen environment. and they fail to grow on the surface of solid medium in 10%
co2 in ambient air.
 CULTURAL
1. Blood Agar
A. Kanamycin or neomycin Blood agar selective for Anaerobes
B. Incubates anaerobically at 37C for 48 hours
C. B.fragilis Form non haemolytic grey colony of 1-3 mm diameter
D. B.melanogenicus form black brown haemolytic colony in 3-5 days
2. Bacteriodes Bile Esculin Agar (BBE)
A. hydrolyses esculin,
B. colony surrounded by dark zone
Good growth on Bacteroides Bile Esculin (BBE) medium and other 20% bile containing media is a
general characteristic of the B. fragilis group
B.fragilis is also cultured by the Bacteroides Amikacin Vancomycin Agar (BAVA) 
 BIOCHEMICAL CHARATERSTICS
1. Urease: Negative (-)
2. Catalase: Positive (+)
3. Oxidase : Variable (+/-)
4. Esculin Hydrolyses: Positive (+)
5. Indole: Negative (-)
6. Fermentative: Glucose +, Lactose +, Maltose +, Sucose + Rhamnose -, Arabinose -, Salicin
-, Trehalose –
7. Bile Resistant: Grow In 20% Bile
8. Thioglycolate With Bile: Positive (+)
9. Beta Lactamase Production: Fragilis Is Resistant To Penicillin.
 EPIDEMIOLOGY PATTERNS
World wide, The bacteroides are the normal flora of the gastrointestinal tract present in
the colon and mouth.
Although Bacteroides fragilis is relatively minor member of the normal flora of the
gastrointestinal tract, more than 80% of all intra abdominal infections are associated with B.
fragilis

 TRANSMISSION
Displacement of their normal habitat. The problem is when it endogenously spreads to
areas where it’s not supposed to go and causes infection.
 VIRULENT FACTORS
1. Capsule
2. Fimbriae
3. Endotoxin (LPS)
4. Short chain Fatty acids (succinic acid)
5. Enzymes- protect from Oxygen toxicity
a. Catalase and Superoxide dismutase f. Protease
b. Collagenase g. Phospholipase
c. Neuraminidase h. Heparinase
d. Haemolysin i. Fibrinolysin
e. Gluconidase
 PATHOGENESIS

 Predisposing factors such as surgery, trauma, and chronic diseases play an important role in pathogenesis.
 Disruption of the mucosal surface either by inflammation, trauma, surgery and spread of bacteroides fragilis to
the blood stream or surrounding tissues result clinical significant infection.
 B fragilis is a very important pathogen among the anaerobes that are part of the normal microbiota.
 The capsular polysaccharides of Bacteroides are important virulence factors. A unique feature of infections with
B fragilis is the ability of the organism to induce abscess formation as the sole infecting organism.
 B fragilis produces an SOD and can survive in the presence of oxygen for days. When a facultative anaerobe
such as E coli is present at the site of infection, it can consume all available oxygen and thereby produce an
environment in which Bacteroides species and other anaerobes can grow
 CLINICAL FEATURES OF DISEASE CAUSED BY ORGANISAM
1. Genitourinary tract infection
2. Appendicitis
3. Bacteremia
4. Endocarditis, pericarditis, vascular graft infection
5. Meningitis
6. Septic arthritis
7. Bed sore
8. Inflammation of viscent angina ( throat)
9. S kin and soft tissue infection
10. Upper respiratory infection
 DIAGNOSTIC WORK UP
Culture
Microscopy (gram stain)
Serology
 TREATMENT (SURGERY, MEDICAL, ANTIBIOTICS)
Antibiotics:
Metronidazole
Cephalosporin
Chloramphenicol
Surgery:
Abscess draining and removal of necrotic tissue.
PREVENTION

 Prophylaxis for gastrointestinal surgical procedures is important in prevention of mixed infections including B. fragilis. 
 B. fragilis include good skin care in diabetic and bed ridden patients to prevent the development of pressure ulcerations.

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