Anaerobes and aerobes are two forms of existence of organisms on earth. This article is about microorganisms.

Anaerobes are microorganisms that develop and multiply in an environment that does not contain free oxygen. Anaerobic microorganisms are found in almost all human tissues from pyoinflammatory foci. They are classified as opportunistic (they exist in humans in the nome and develop only in people with a weakened immune system), but sometimes they can be pathogenic (pathogenic).

There are facultative and obligate anaerobes. Facultative anaerobes can develop and multiply both in oxygen-free and oxygen environments. These are microorganisms such as E. coli, Yersinia, staphylococcus, streptococcus, shigella and other bacteria. Obligate anaerobes can only exist in an anoxic environment and die when free oxygen appears in the environment. Obligate anaerobes are divided into two groups:

• spore-forming bacteria, otherwise known as clostridia
• bacteria that do not form spores, or otherwise non-clostridial anaerobes.

Clostridium is the causative agent of anaerobic clostridial infections - botulism, clostridial wound infections, tetanus. Non-clostridial anaerobes are the normal microflora of humans and animals. These include rod-shaped and spherical bacteria: bacteroids, fusobacteria, peillonella, peptococci, peptostreptococci, propionibacteria, eubacteria and others.

But non-clostridial anaerobes can significantly contribute to the development of purulent-inflammatory processes (peritonitis, abscesses of the lungs and brain, pneumonia, pleural empyema, phlegmon of the maxillofacial region, sepsis, otitis, and others). Most anaerobic infections caused by non-clostridial anaerobes are endogenous (of internal origin, caused by internal causes) and develop mainly with a decrease in body resistance, resistance to pathogens as a result of injuries, operations, hypothermia, and reduced immunity.

The main part of the anaerobes that play a role in the development of infections are bacteroids, fusobacteria, peptostreptococci and spore bacilli. Half of purulent-inflammatory anaerobic infections are caused by bacteroids.

• Bacteroides-rods, 1-15 microns in size, non-motile or moving with the help of flagella. They secrete toxins that act as virulence factors (pathogens).
• Fusobacteria are rod-shaped obligate (surviving only in the absence of oxygen) anaerobic bacteria that live on the mucous membrane of the mouth and intestines, can be immobile or mobile, contain a strong endotoxin.
• Peptostreptococci are spherical bacteria, arranged in twos, fours, irregular clusters or chains. These are non-flagellated bacteria that do not form spores. Peptococci is a genus of spherical bacteria represented by a single species P.niger. Arranged singly, in pairs or in clusters. Peptococci do not have flagella and do not form spores.
• Veyonella is a genus of diplococci (bacteria of a coccal form, the cells of which are arranged in pairs), arranged in short chains, immobile, do not form spores.
• Other non-clostridial anaerobic bacteria that are isolated from infectious foci of patients are propionic bacteria, volinella, the role of which is less studied.

Clostridium is a genus of spore-forming anaerobic bacteria. Clostridia live on the mucous membranes of the gastrointestinal tract. Clostridia are mainly pathogenic (disease-causing) for humans. They secrete highly active toxins specific to each species. The causative agent of anaerobic infection can be either one type of bacteria or several types of microorganisms: anaerobic-anaerobic (bacteroids and fusobacteria), anaerobic-aerobic (bacteroids and staphylococci, clostridia and staphylococci)

Aerobes are organisms that need free oxygen for life and reproduction. Unlike anaerobes, aerobes take part in the process of generating the energy they need. Aerobes include animals, plants and a significant part of microorganisms, among which they are isolated.

• obligate aerobes - these are "strict" or "unconditional" aerobes, they receive energy only from oxidative reactions involving oxygen; these include, for example, some species of Pseudomonas, many saprophytes, fungi, Diplococcus pneumoniae, diphtheria bacilli
• in the group of obligate aerobes, microaerophiles can be distinguished - for their vital activity they need a low oxygen content. When released into the normal environment, such microorganisms are suppressed or killed, since oxygen adversely affects the action of their enzymes. These include, for example, meningococci, streptococci, gonococci.
• facultative aerobes - microorganisms that can develop in the absence of oxygen, for example, a yeast bacillus. Most pathogenic microbes belong to this group.

Each aerobic microorganism has its own minimum, optimum and maximum oxygen concentration in its environment, which is necessary for its normal development. Increasing the oxygen content beyond the “maximum” boundary leads to the death of microbes. All microorganisms die at an oxygen concentration of 40-50%.

Bacteria are present everywhere, their number is huge, the species are different. anaerobic bacteria- the same types of microorganisms. They can develop and live independently, whether there is oxygen in their feeding environments or it does not exist at all.

Anaerobic bacteria obtain energy from substrate phosphorylation. There are facultative aerobes, obligate or other varieties of anaerobic bacteria.

Facultative species of bacteria are almost everywhere. The reason for their existence is the change of one metabolic pathway to a completely different one. This species includes E. coli, staphylococci, shigella, and others. These are dangerous anaerobic bacteria.

If there is no free oxygen, obligate bacteria die.

Arranged by class:

1. Clostridia- obligate types of aerobic bacteria, can form spores. These are the causative agents of botulism or tetanus.
2. non-clostridial anaerobic bacteria. Varieties from the microflora of living organisms. They play a significant role in the formation of various purulent and inflammatory diseases. Non-spore-forming types of bacteria live in the oral cavity, in the gastrointestinal tract. On the skin, in the genitals of women.
3. Capneistic anaerobes. They live with an exaggerated accumulation of carbon dioxide.
4. Aerotolerant bacteria. In the presence of molecular oxygen, this type of microorganisms has no respiration. But he doesn't die either.
5. Moderately strict types of anaerobes. In an environment with oxygen, they do not die, do not multiply. Bacteria of this species require a nutritional environment with reduced pressure to live.

Anaerobes - bacteroids

Considered the most important aerobic bacteria. They make up 50% of all inflammatory and purulent types. Their causative agents are anaerobic bacteria or bacteroids. These are gram-negative obligate types of bacteria.

Rods with bipolar staining and sizes from 0.5 to 1.5, in areas of approximately 15 microns. They can produce the production of enzymes, toxins, cause virulence. dependent on antibiotic resistance. They can be persistent or just sensitive. All anaerobic microorganisms are very resistant.

The formation of energy for gram-negative obligate anaerobes is carried out in human tissues. Some of the tissues of organisms have increased resistance to reduced oxygen in the food environment.

Under the conditions of the standard, the synthesis of adenosine triphosphate is performed only aerobically. This occurs with increased physical effort, inflammation, where anaerobes act.

ATP is adenosine triphosphate or acid, which appears during the formation of energy in the body. There are several variations of the synthesis of this substance. One of them is aerobic, or there are three variations of anaerobes.

Anaerobic mechanisms for the synthesis of adenosine triphosphate:

• rephosphorylation, which is carried out between adenosine triphosphate and creatine phosphate;
• the formation of transphosphorylation of adenosine triphosphate molecules;
• anaerobic breakdown of blood components of glucose, glycogen.

Formation of anaerobes

The purpose of microbiologists is the cultivation of anaerobic bacteria. To do this requires a specialized microflora, and the concentration of metabolites. It is usually used in research of a different nature.

There are special methods for growing anaerobes. Occur when replacing air with a mixture of gases. There is an action in thermostats with sealing. This is how anaerobes grow. Another method is the cultivation of microorganisms with the addition of reducing agents.

Sphere of nutrition

There is a sphere of nutrition with a general view or differential diagnostic. The base - for the type of Wilson-Blair is agar-agar, which has some content of glucose, 2-x iron chloride, sodium sulfite among the components. Among them there are colonies that are called black.

The Ressel sphere is used in the study of the biochemical qualities of bacteria called Salmonella or Shigella. This medium may contain both glucose and agar-agar.

Ploskirev's environment is such that it can inhibit the growth of certain microorganisms. They make up a multitude. For this reason, it is used for the possibility of differential diagnostic. Here, dysentery pathogens, typhoid fever, and other pathogenic anaerobes can be successfully produced.

The main direction of the bismuth-sulfite agar medium is the isolation of Salmonella by this method. This is done with the ability of Salmonella to produce hydrogen sulfide.

In the body of every living individual, many anaerobes live. They cause various types of infectious diseases in them. Infection with an infection can occur only with a weakened immune system or disruption of the microflora. There is a possibility of infection getting into a living organism from the environment. It could be in autumn, in winter. Such hit of infections is saved during the listed periods. The ailment caused sometimes gives complications.

Infections caused by microorganisms - anaerobic bacteria, are directly linked to the flora of the mucous membranes of living individuals. With living places anaerobes. Each infection has several pathogens. Their number usually reaches ten. An absolutely specified number of diseases that cause anaerobe cannot be determined with accuracy.

Due to the difficult selection of materials intended for the study of the transportation of samples, the determination of bacteria. Therefore, this type of component is often found only with already chronic inflammation in humans. This is an example of a careless attitude to one's health.

Anaerobic infections are periodically exposed to absolutely all people with different ages. In small children, the degree of infectious inflammation is much greater than in people of other ages. Anaerobes often cause diseases inside the skull in humans. Abscesses, meningitis, other types of diseases. The spread of anaerobes is carried out with blood flow.

If a person has a chronic disease, then anaerobes can form anomalies in the neck or head. For example: abscesses, otitis or lymphadenitis. Bacteria are dangerous for the gastrointestinal tract, lungs of patients.

If a woman has diseases of the genitourinary system, then there is a risk of anaerobic infections. Various diseases of the skin, joints - this is also a consequence of the life of anaerobes. This method is one of the first to indicate the presence of an infection.

Reasons for the appearance of infectious diseases

Human infections are caused by those processes in which energetic anaerobe bacteria enter the body. The development of the disease may be accompanied by unstable blood supply, the appearance of tissue necrosis. These can be injuries of a different nature, swelling, tumors, vascular disorders. The appearance of infections in the oral cavity, diseases in the lungs, inflammation of the pelvic organs, other diseases.

Infection can develop in a peculiar way for each species. The development is influenced by the type of pathogen, the health of the patient. It is difficult to diagnose such infections. The seriousness of diagnosticians is often based on assumptions alone. There is a difference in the characteristics of infections that arise from non-clostridial anaerobes.

The first signs of infection are gas formation, any suppuration, the appearance of thrombophlebitis. Sometimes tumors or neoplasms can be signs as signs. They can be neoplasms of the gastrointestinal tract, uterine. Accompanied by the formation of anaerobes. At this time, an unpleasant odor may come from a person. But, even if the smell does not exist, this does not mean that there are no anaerobes as pathogens for infection in this organism.

Features for getting samples

The first study for infections caused by anaerobes is an external examination of the general appearance of a person, his skin. Because the presence of skin diseases in humans is a complication. They indicate that the vital activity of bacteria is the presence of gases in infected tissues.

In laboratory studies, determining a refined diagnosis, it is necessary to correctly obtain a sample of infected matter. Often specialized equipment is used. The best method of obtaining samples is considered to be aspiration performed with a straight needle.

Types of samples that do not correspond to the possibility of continuing analyzes:

• sputum acquired by self-excretion;
• bronchoscopy samples;
• types of smears from the vaults of the vagina;
• urine from free urination;
• types of faeces.

Samples are subject to research:

1. blood;
2. pleural fluid;
3. transtracheal aspirates;
4. pus taken from abscesses
5. fluid from the brain back;
6. lung punctures.

Samples must be moved to their destination quickly. Work is carried out in a specialized container, sometimes in a plastic bag.

It must be designed for anaerobic conditions. Because the interaction of samples with atmospheric oxygen can cause the complete death of bacteria. Liquid types of samples are moved in test tubes, sometimes directly in syringes.

If swabs are moved for research, then they are transported only in test tubes with the presence of carbon dioxide, sometimes with pre-made substances.

Bacteria are present everywhere in our world. They are everywhere and everywhere, and the number of their varieties is simply amazing.

Depending on the need for the presence of oxygen in the nutrient medium for the implementation of vital activity, microorganisms are classified into the following types.

• Obligate aerobic bacteria, which are collected in the upper part of the nutrient medium, the flora contained the maximum amount of oxygen.
• Obligate anaerobic bacteria, which are located in the lower part of the environment, as far as possible from oxygen.
• Facultative bacteria mainly live in the upper part, but can be distributed throughout the environment, as they do not depend on oxygen.
• Microaerophiles prefer a low concentration of oxygen, although they gather in the upper part of the environment.
• Aerotolerant anaerobes are evenly distributed in the nutrient medium, insensitive to the presence or absence of oxygen.

The concept of anaerobic bacteria and their classification

The term "anaerobes" appeared in 1861, thanks to the work of Louis Pasteur.

Anaerobic bacteria are microorganisms that develop regardless of the presence of oxygen in the nutrient medium. They get energy by substrate phosphorylation. There are facultative and obligate aerobes, as well as other types.

The most significant anaerobes are bacteroides

The most important aerobes are bacteroids. About fifty percent of all purulent-inflammatory processes, the causative agents of which can be anaerobic bacteria, are bacteroids.

Bacteroides are a genus of Gram-negative obligate anaerobic bacteria. These are rods with bipolar coloration, the size of which does not exceed 0.5-1.5 by 15 microns. They produce toxins and enzymes that can cause virulence. Different bacteroids have different resistance to antibiotics: there are both resistant and susceptible to antibiotics.

Energy production in human tissues

Some tissues of living organisms have increased resistance to low oxygen content. Under standard conditions, the synthesis of adenosine triphosphate occurs aerobically, but with increased physical exertion and inflammatory reactions, the anaerobic mechanism comes to the fore.

Adenosine triphosphate (ATP) It is an acid that plays an important role in the body's energy production. There are several options for the synthesis of this substance: one aerobic and as many as three anaerobic.

Anaerobic mechanisms of ATP synthesis include:

• rephosphorylation between creatine phosphate and ADP;
• transphosphorylation reaction of two ADP molecules;
• anaerobic breakdown of blood glucose or glycogen stores.

Cultivation of anaerobic organisms

There are special methods for growing anaerobes. They consist in replacing air with gas mixtures in sealed thermostats.

Another way is to grow microorganisms in a nutrient medium to which reducing substances are added.

Culture media for anaerobic organisms

There are common nutrient media and differential diagnostic nutrient media. Common ones include the Wilson-Blair medium and the Kitt-Tarozzi medium. For differential diagnostic - Hiss medium, Ressel medium, Endo medium, Ploskirev medium and bismuth-sulfite agar.

The basis for the Wilson-Blair medium is agar-agar with the addition of glucose, sodium sulfite and iron dichloride. Black colonies of anaerobes are formed mainly in the depth of the agar column.

Ressel's (Russell's) medium is used in the study of the biochemical properties of bacteria such as Shigella and Salmonella. It also contains agar-agar and glucose.

Wednesday Ploskirev inhibits the growth of many microorganisms, so it is used for differential diagnostic purposes. In such an environment, pathogens of typhoid fever, dysentery and other pathogenic bacteria develop well.

The main purpose of bismuth sulfite agar is the isolation of salmonella in its pure form. This environment is based on the ability of Salmonella to produce hydrogen sulfide. This medium is similar to the Wilson-Blair medium in the technique used.

Anaerobic infections

Most anaerobic bacteria living in the human or animal body can cause various infections. As a rule, infection occurs during a period of weakened immunity or a violation of the general microflora of the body. There is also the possibility of infection pathogens from the external environment, especially in late autumn and winter.

Infections caused by anaerobic bacteria are usually associated with the flora of the human mucous membranes, that is, with the main habitats of anaerobes. Typically, these infections multiple triggers at once(to 10).

The exact number of diseases caused by anaerobes is almost impossible to determine due to the difficulty in collecting materials for analysis, transporting samples and cultivating the bacteria themselves. Most often, this type of bacteria is found in chronic diseases.

Anaerobic infections affect people of all ages. At the same time, the level of infectious diseases in children is higher.

Anaerobic bacteria can cause various intracranial diseases (meningitis, abscesses, and others). Distribution, as a rule, occurs with the blood stream. In chronic diseases, anaerobes can cause pathologies in the head and neck: otitis media, lymphadenitis, abscesses. These bacteria are dangerous to both the gastrointestinal tract and the lungs. With various diseases of the urogenital female system, there is also a risk of developing anaerobic infections. Various diseases of the joints and skin can be the result of the development of anaerobic bacteria.

Causes of anaerobic infections and their symptoms

Infections are caused by all processes during which active anaerobic bacteria enter the tissues. Also, the development of infections can cause impaired blood supply and tissue necrosis (various injuries, tumors, edema, vascular disease). Mouth infections, animal bites, lung diseases, pelvic inflammatory disease and many other diseases can also be caused by anaerobes.

In different organisms, the infection develops in different ways. This is influenced by the type of pathogen, and the state of human health. Because of the difficulties associated with diagnosing anaerobic infections, the conclusion is often based on assumptions. Differ in some features of the infection caused by non-clostridial anaerobes.

The first signs of infection of tissues with aerobes are suppuration, thrombophlebitis, gas formation. Some tumors and neoplasms (intestinal, uterine and others) are also accompanied by the development of anaerobic microorganisms. With anaerobic infections, an unpleasant odor may appear, however, its absence does not exclude anaerobes as the causative agent of the infection.

Features of obtaining and transporting samples

The very first study in determining infections caused by anaerobes is a visual inspection. Various skin lesions are a common complication. Also, evidence of the vital activity of bacteria will be the presence of gas in infected tissues.

For laboratory research and establishing an accurate diagnosis, first of all, it is necessary to competently get matter sample from the affected area. For this, a special technique is used, thanks to which normal flora does not get into the samples. The best method is aspiration with a straight needle. Obtaining laboratory material by smears is not recommended, but possible.

Samples not suitable for further analysis include:

• sputum obtained by self-excretion;
• samples obtained during bronchoscopy;
• smears from the vaginal vaults;
• urine with free urination;
• feces.

For research can be used:

• blood;
• pleural fluid;
• transtracheal aspirates;
• pus obtained from the abscess cavity;
• cerebrospinal fluid;
• lung punctures.

Transport samples it is necessary as soon as possible in a special container or plastic bag with anaerobic conditions, since even a short-term interaction with oxygen can cause the death of bacteria. Liquid samples are transported in a test tube or in syringes. Swabs with samples are transported in test tubes with carbon dioxide or pre-prepared media.

In the case of diagnosing an anaerobic infection for adequate treatment, it is necessary to follow the following principles:

• toxins produced by anaerobes must be neutralized;
• the habitat of bacteria should be changed;
• the spread of anaerobes must be localized.

To comply with these principles antibiotics are used in treatment, which affect both anaerobes and aerobic organisms, since often the flora in anaerobic infections is mixed. At the same time, when prescribing drugs, the doctor must evaluate the qualitative and quantitative composition of the microflora. The agents that are active against anaerobic pathogens include: penicillins, cephalosporins, champhenicol, fluoroquinolo, metranidazole, carbapenems and others. Some drugs have a limited effect.

To control the habitat of bacteria, in most cases, surgical intervention is used, which is expressed in the treatment of affected tissues, drainage of abscesses, and ensuring normal blood circulation. Surgical methods should not be ignored because of the risk of life-threatening complications.

Sometimes used ancillary therapies, and also because of the difficulties associated with the exact determination of the causative agent of the infection, empirical treatment is used.

With the development of anaerobic infections in the oral cavity, it is also recommended to add as many fresh fruits and vegetables to the diet as possible. The most useful are apples and oranges. The restriction is subjected to meat food and fast food.

Aerobic organisms are those organisms that are able to live and develop only in the presence of free oxygen in the environment, which they use as an oxidizing agent. All plants, most protozoa and multicellular animals, almost all fungi, that is, the vast majority of known species of living beings, belong to aerobic organisms.

In animals, life in the absence of oxygen (anaerobiosis) occurs as a secondary adaptation. Aerobic organisms carry out biological oxidation mainly through cellular respiration. In connection with the formation of toxic products of incomplete oxygen reduction during oxidation, aerobic organisms have a number of enzymes (catalase, superoxide dismutase) that ensure their decomposition and are absent or poorly functioning in obligate anaerobes, for which oxygen turns out to be toxic as a result.

The respiratory chain is most diverse in bacteria that possess not only cytochrome oxidase, but also other terminal oxidases.

A special place among aerobic organisms is occupied by organisms capable of photosynthesis - cyanobacteria, algae, vascular plants. The oxygen released by these organisms ensures the development of all other aerobic organisms.

Organisms that can grow at low oxygen concentrations (≤ 1 mg/l) are called microaerophiles.

Anaerobic organisms are able to live and develop in the absence of free oxygen in the environment. The term "anaerobes" was introduced by Louis Pasteur, who discovered butyric fermentation bacteria in 1861. They are distributed mainly among prokaryotes. Their metabolism is due to the need to use other oxidizing agents than oxygen.

Many anaerobic organisms that use organic substances (all eukaryotes that receive energy as a result of glycolysis) carry out various types of fermentation, in which reduced compounds are formed - alcohols, fatty acids.

Other anaerobic organisms - denitrifying (some of them reduce iron oxide), sulfate-reducing, methane-forming bacteria - use inorganic oxidizing agents: nitrate, sulfur compounds, CO 2.

Anaerobic bacteria are divided into groups of butyric, etc. according to the main product of exchange. A special group of anaerobes are phototrophic bacteria.

In relation to O 2, anaerobic bacteria are divided into bonds, who are unable to use it in exchange, and optional(for example, denitrifying), which can go from anaerobiosis to growth in an environment with O 2 .

Per unit of biomass, anaerobic organisms form many reduced compounds, of which they are the main producers in the biosphere.

The sequence of formation of reduced products (N 2 , Fe 2+, H 2 S, CH 4) observed during the transition to anaerobiosis, for example, in bottom sediments, is determined by the energy yield of the corresponding reactions.

Anaerobic organisms develop under conditions when O 2 is completely used by aerobic organisms, for example, in sewage and sludge.

Influence of the amount of dissolved oxygen on the species composition and abundance of hydrobionts.

The degree of saturation of water with oxygen is inversely proportional to its temperature. The concentration of dissolved O 2 in surface waters varies from 0 to 14 mg/l and is subject to significant seasonal and daily fluctuations, which mainly depend on the ratio of the intensity of its production and consumption processes.

In the case of a high intensity of photosynthesis, water can be significantly supersaturated with O 2 (20 mg/l and more). In the aquatic environment, oxygen is the limiting factor. O 2 is in the atmosphere 21% (by volume) and about 35% of all gases dissolved in water. Its solubility in sea water is 80% of that in fresh water. The distribution of oxygen in a reservoir depends on temperature, the movement of water layers, as well as the nature and number of organisms living in it.

The endurance of aquatic animals to low oxygen content varies among species. Among the fish, four groups have been established according to their relationship to the amount of dissolved oxygen:

1) 7 - 11 mg / l - trout, minnow, sculpin;

2) 5 - 7 mg / l - grayling, gudgeon, chub, burbot;

3) 4 mg/l - roach, ruff;

4) 0.5 mg / l - carp, tench.

Some types of organisms have adapted to seasonal rhythms in the consumption of O 2 associated with living conditions.

Thus, in the crustacean Gammarus Linnaeus, it was found that the intensity of respiratory processes increases with temperature and changes throughout the year.

In animals living in places poor in oxygen (coastal silt, bottom silt), respiratory pigments have been found that serve as a reserve of oxygen.

These species are able to survive by passing to a slow life, to anaerobiosis, or due to the fact that they have d-hemoglobin, which has a high affinity for oxygen (daphnia, oligochaetes, polychaetes, some lamella-gill mollusks).

Other aquatic invertebrates rise to the surface for air. These are adults of swimming beetles and aquatic beetles, smooth fish, water scorpions and water bugs, pond snails and coil (gastropod mollusks). Some beetles surround themselves with an air bubble held by a hair, and insects can use air from the airways of aquatic plants.

Anaerobic infections give the patient a lot of trouble, as their manifestations are acute and aesthetically unpleasant. The provocateurs of this group of diseases are spore-forming or non-spore-forming microorganisms that have fallen into favorable conditions for life.

Infections caused by anaerobic bacteria develop rapidly, can affect vital tissues and organs, so their treatment should be started immediately after diagnosis in order to avoid complications or death.

What it is?

Anaerobic infection is a pathology, the causative agents of which are bacteria that can grow and multiply in the complete absence of oxygen or its low voltage. Their toxins are highly penetrating and are considered extremely aggressive.

This group of infectious diseases includes severe forms of pathologies characterized by damage to vital organs and a high mortality rate. In patients, manifestations of intoxication syndrome usually predominate over local clinical signs. This pathology is characterized by a predominant lesion of connective tissue and muscle fibers.

Causes of anaerobic infection

Anaerobic bacteria are classified as conditionally pathogenic and are part of the normal microflora of the mucous membranes, digestive and genitourinary systems and skin. Under conditions that provoke their uncontrolled reproduction, an endogenous anaerobic infection develops. Anaerobic bacteria that live in decaying organic debris and soil, when released into open wounds, cause exogenous anaerobic infection.

The development of anaerobic infection is facilitated by tissue damage, which creates the possibility of penetration of the pathogen into the body, the state of immunodeficiency, massive bleeding, necrotic processes, ischemia, and some chronic diseases. Potential danger is represented by invasive manipulations (tooth extraction, biopsy, etc.), surgical interventions. Anaerobic infections can develop as a result of contamination of wounds with earth or other foreign bodies entering the wound, against the background of traumatic and hypovolemic shock, irrational antibiotic therapy that suppresses the development of normal microflora.

In relation to oxygen, anaerobic bacteria are divided into facultative, microaerophilic and obligate. Facultative anaerobes can develop both under normal conditions and in the absence of oxygen. This group includes staphylococci, E. coli, streptococci, shigella and a number of others. Microaerophilic bacteria are an intermediate link between aerobic and anaerobic, oxygen is necessary for their vital activity, but in small quantities.

Among obligate anaerobes, clostridial and non-clostridial microorganisms are distinguished. Clostridial infections are exogenous (external). These are botulism, gas gangrene, tetanus, food poisoning. Representatives of non-clostridial anaerobes are the causative agents of endogenous purulent-inflammatory processes, such as peritonitis, abscesses, sepsis, phlegmon, etc.

Symptoms

The incubation period lasts about three days. Anaerobic infection begins suddenly. In patients, symptoms of general intoxication predominate over local inflammation. Their health deteriorates sharply until local symptoms appear, the wounds become black in color.

Patients have fever and shivering, they experience severe weakness and weakness, dyspepsia, lethargy, drowsiness, apathy, blood pressure drops, heartbeat quickens, the nasolabial triangle turns blue. Gradually, lethargy is replaced by excitement, restlessness, confusion. Their breathing and pulse speed up.

The state of the gastrointestinal tract also changes: the tongue of patients is dry, lined, they experience thirst and dry mouth. The skin of the face turns pale, acquires an earthy tint, the eyes sink. There is a so-called "Hippocratic mask" - "fades Hippocratica". Patients become inhibited or sharply excited, apathetic, depressive. They cease to navigate in space and their own feelings.

Local symptoms of pathology:

1. Edema of the tissues of the limb progresses rapidly and is manifested by sensations of fullness and fullness of the limb.
2. Severe, unbearable, growing pain of a bursting nature, not relieved by analgesics.
3. The distal parts of the lower extremities become inactive and practically insensitive.
4. Purulent-necrotic inflammation develops rapidly and even malignantly. In the absence of treatment, soft tissues are rapidly destroyed, which makes the prognosis of the pathology unfavorable.
5. Gas in the affected tissues can be detected using palpation, percussion and other diagnostic techniques. Emphysema, soft tissue crepitus, tympanitis, slight crackle, box sound are signs of gas gangrene.

The course of anaerobic infection can be fulminant (within 1 day from the moment of surgery or injury), acute (within 3-4 days), subacute (more than 4 days). Anaerobic infection is often accompanied by the development of multiple organ failure (renal, hepatic, cardiopulmonary), infectious-toxic shock, severe sepsis, which are the cause of death.

Diagnosis of anaerobic infection

Before starting treatment, it is important to determine exactly whether an anaerobic or aerobic microorganism has caused the infection, and for this it is not enough only to assess the symptoms externally. Methods for determining an infectious agent can be different:

• ELISA blood test (the efficiency and speed of this method is high, as is the price);
• radiography (this method is most effective in diagnosing infection of the bones and joints);
• bacterial culture of pleural fluid, exudate, blood or purulent discharge;
• Gram stain of taken smears;

Treatment of anaerobic infection

With anaerobic infection, an integrated approach to treatment involves radical surgical treatment of a purulent focus, intensive detoxification and antibiotic therapy. The surgical stage should be performed as early as possible - the life of the patient depends on it.

As a rule, it consists in a wide dissection of the lesion with the removal of necrotic tissues, decompression of surrounding tissues, open drainage with washing of cavities and wounds with antiseptic solutions. Features of the course of anaerobic infection often require repeated necrectomy, opening of purulent pockets, treatment of wounds with ultrasound and laser, ozone therapy, etc. With extensive tissue destruction, amputation or disarticulation of the limb may be indicated.

The most important components of the treatment of anaerobic infections are intensive infusion therapy and antibiotic therapy with broad-spectrum drugs highly tropic to anaerobes. As part of the complex treatment of anaerobic infections, hyperbaric oxygenation, UBI, extracorporeal hemocorrection (hemosorption, plasmapheresis, etc.) are used. If necessary, the patient is injected with antitoxic antigangrenous serum.

Forecast

The outcome of anaerobic infection largely depends on the clinical form of the pathological process, premorbid background, timeliness of diagnosis and initiation of treatment. The mortality rate in some forms of anaerobic infection exceeds 20%.