Infections caused by anaerobic bacteria can occur in children, and may be serious and life-threatening. The recent increased recovery of these organisms from children has led to greater appreciation of the role anaerobes play in pediatric infections at all body sites, including the bacteremia.
Anaerobes are one of the predominant components of the normal human skin flora and the most predominant component of the bacterial flora of the mucous membranes , and are therefore a common cause of bacterial infections of endogenous origin. Because of their fastidious nature, these organisms are difficult to isolate from infectious sites, and are often overlooked. Their exact frequency is difficult to ascertain because of the inconsistent use of adequate methods for their isolation and identification. A lack of direct adequate therapy against these organisms may lead to clinical failures. Their isolation requires appropriate methods of collection, transportation and cultivation of specimens . Treatment of anaerobic infection is complicated by the slow growth of these organisms, by their polymicrobial nature and by the growing resistance of anaerobic bacteria to antimicrobial drugs.
Although anaerobes have been reported to account for 8% to 11% of episodes of bacteremia in adults , anaerobic organisms have rarely been isolated from blood cultures of pediatric patients. These microbes represent a small percentage of the total number of positive blood cultures recovered from children, which may be because of the difficulty in isolating and identifying these organisms. There is, however, a growing awareness of the role of anaerobes in bacteremia [2,3,4,5,6,7], especially in children with certain predisposing conditions and in newborns, who are at high risk, and in those with necrotizing enterocolitis. This review describes the microbiology and management of bacteremia due to anaerobic bacteria in children.