Overview of Anaerobic Bacteria - Infectious Diseases - Merck Manual Professional Editionhoneypot linkskip to main contentProfessionalConsumerMEDICAL TOPICSRESOURCESDRUG INFOCOMMENTARYPROCEDURESQUIZZESABOUT US Professional/Infectious Diseases/Anaerobic Bacteria/Overview of Anaerobic Bacteria/Overview of Anaerobic BacteriaBy, MD, FACP, Charles E. Schmidt College of Medicine, Florida Atlantic University;, MD, FACP, Wellington Regional Medical CenterReviewed By, MD, University of Rochester School of Medicine and DentistryReviewed/Revised Jun 2023View Patient EducationBacteria can be classified by their need and tolerance for oxygen:Facultative: Grow aerobically or anaerobically in the presence or absence of oxygenMicroaerophilic: Require a low oxygen concentration (typically 2 to 10%) and, for many, a high carbon dioxide concentration (eg, 10%); grow very poorly anaerobicallyObligate anaerobic: Are incapable of aerobic metabolism but are variably tolerant of oxygenObligate anaerobes replicate at sites with low oxidation-reduction potential (eg, necrotic, devascularized tissue). Oxygen is toxic to them. Obligate anaerobes have been categorized based on their oxygen tolerance: Strict: Tolerate only ≤ 0.5% oxygenModerate: Tolerate 2 to 8% oxygenAerotolerant anaerobes: Tolerate atmospheric oxygen for a limited timeThe obligate anaerobes that commonly cause infection can tolerate atmospheric oxygen for at least 8 hours and frequently for up to 72 hours.Obligate anaerobes are major components of the normal microflora on mucous membranes, especially of the oral cavity (gingival, odontogenic, and pharyngeal), lower gastrointestinal (GI) tract, and vagina; these anaerobes cause disease when normal mucosal barriers break down.Gram-negative anaerobes and some of the infections they cause includeBacteroides (most common): Intra-abdominal infectionsFusobacterium: Abscesses, wound infections, and pulmonary and intracranial infections Porphyromonas: Aspiration pneumonia and periodontitisPrevotella: Intra-abdominal, dental, gynecologic, and soft-tissue infectionsGram-positive anaerobes and some of the infections they cause includeActinomyces: Head, neck, abdominal, bone, and pelvic infections and aspiration pneumonia (actinomycosis)Clostridia: Intra-abdominal infections (eg, clostridial necrotizing enteritis), soft-tissue infections, and gas gangrene due to C. perfringens; food poisoning due to C. perfringens type A; botulism and infant botulism due to C. botulinum; tetanus due to C. tetani; and Clostridioides (formerly Clostridium) difficile–induced colitis and diarrhea (pseudomembranous colitis)Peptostreptococcus and Finegoldia (formerly Peptostreptococcus magnus): Oral, respiratory, bone and joint, soft-tissue, and intra-abdominal infectionsCutibacterium (formerly Propionibacterium): Foreign body infections (eg, in a cerebrospinal fluid shunt, prosthetic joint, or cardiac device); acne vulgarisAnaerobic infections are typically suppurative, causing abscess formation and tissue necrosis and sometimes septic thrombophlebitis, gas formation, or both. Many anaerobes produce tissue-destructive enzymes, as well as some of the most potent paralytic toxins known (eg, C. botulinum and C. tetani neurotoxins).Usually, multiple species of anaerobes are present in infected tissues; aerobes are frequently also present (mixed anaerobic infections).Clues to anaerobic infection includePolymicrobial results on Gram stain or cultureBacteria are seen on Gram stain, but aerobic cultures are sterileGas in pus or infected tissuesFoul odor of pus or infected tissuesNecrotic infected tissuesSite of infection near mucosa where anaerobic microflora normally resideTestingSpecimens for anaerobic culture should be obtained by aspiration or biopsy from normally sterile sites. Delivery to the laboratory should be prompt, and transport devices should provide an oxygen-free atmosphere of carbon dioxide, hydrogen, and nitrogen. Swabs are best transported in an anaerobically sterilized, semisolid medium such as the anaerobic pre-reduced formulation of Cary-Blair transport medium.Test your KnowledgeTake a Quiz!, Anaerobic bacteria are bacteria capable of living in the absence of molecular oxygen. In general, these bacteria do not require oxygen for their growth and metabolism although some of them (referred to as facultative anaerobic bacteria) are capable of using oxygen when present and carry out aerobic respiration., Overview of Anaerobic Bacteria - Etiology, pathophysiology, symptoms, signs, diagnosis & prognosis from the Merck Manuals - Medical Professional Version..