Goldstein, EJC. *
R.M. Alden Research Laboratory, Santa Monica-UCLA Medical Center, Santa Monica, CA, USA

Anaerobes are involved in medical, surgical, obstetrical, gynecological and pediatric infections. Anaerobic bacteremia often involves B. fragilis group species, clostridia and pepto- streptococci. While the incidence has been stable, their relative frequency has declined owing to increases in candidemia and coagulase-negative staphylococci bacteremia. The attributable mortality is approx. 19 %. The role of anaerobes is increasingly recognized in oral infections including those of dental implants as well as gingivitis and periodontitis. Aspiration of the oral flora often leads to an anaerobic component of pneumonia, both community- and nosocomially- acquired. Anaerobes are involved in > 60% of dog, cat and human bite wound infections, especially those that are more serious. These include many new species as Bacteroides tectum and P. salivosa and P. canoris. Anaerobic cellulitis, including necrotizing fascutis and clostridial gas gangrene are medical and surgical emergencies with a high mortality. Diabetic foot infections often involve anaerobes especially members of the B. fragilis group. Amputations can be avoided if early and aggressive antimicrobial therapy is instituted. Intra-abdominal infections almost always involve anaerobes. New organisms have been isolated from them include Bilophila wadswothia and Sutterella wadsworthensis. The role of anaerobes in diarrheal diseases has increased with the recognition of Anaerobiosporilum thomasii and toxogenic B. fragilis. Toxogenic B. fragilis may also have a greater affinity for bacteremia. It is likely that there are many more anaerobes not yet isolated nor identified and that their role in a variety of diseases yet remains to be described.