Bacteroides and Prevotella – howMed

Bacteroides and Prevotella are gram negative rods, non- spore forming, encapsulated, anaerobic and non-motile bacteria.

Route of entry
Part of normal flora, colonize human colon and vagina.

Pathogenesis

•    Infections are endogenous, following a break in the mucosal surface, organism causes infections. •    Local abscesses are formed at the site of mucosal breaks. •    Metastatic abscesses form by hematogenous spread to other organs. •    Lung abscesses occur by aspiration of oral flora. •    Facultative anaerobic conditions are required. •    Endotoxin (lipopolysaccharide) produces sepsis and septic shock

•    Enzymes causes tissue damage:

  • Hyaluronidese
  • Collagenose
  • Phospholipase

•    Polysaccharide capsule is antiphagocytic

Virulence Factors •    Capsule •    Endotoxin-LPS •    Hyaluronidase •    Collagenase. •    Phospholipase

•    B- lactamase

Predisposing Factors •    Surgery •    Trauma •    Chronic disease •    Local tissue necrosis •    Impaired blood supply

•    Growth of facultative anaerobes at the site

Clinical Symptoms   •    Intra-abdominal infections •    Pelvic abscesses

•    Necrotizing bacteremia

Bacillus Fragilis causes disease below the diaphragm and B. melaninogenicus causes disease above the diaphragm.

Lab Diagnosis

Specimen •    Pus •    Exudates •    Inflected tissue

•    Blood

Microscopy

Important features observed under microscope include: •    Gram- negative rods •    Non- spore forming •    Capsulate •    Anaerobic

•    Non- Motile

Bacteroides growing on blood agar

Culture

Blood agar plus vancomycin    
Grey, glistening colonies are formed which are non- haemolytic

Biochemical Tests •     Sugar fermentation

•    Organic acid production detected by gas chromatography

Serological Tests
•    PCR

Treatment
•    Penicillin resistant because of B- lactamose
•    Metronidazole with clindamycin is given