The significance of anaerobes in neonatal bacteremia: analysis of 23 cases and review of the literature

Twenty-three newborn infants with anaerobic bacteremia were seen during a 3½-year period, an incidence of 1.8 cases per 1,000 live births, and 26% of all cases of neonatal bacteremia. Clinical manifestations of neonatal anaerobic bacteremia were indistinguishable from other causes of neonatal sepsis. Prolonged rupture of membranes, maternal amnionitis, prematurity, fetal distress, foul odor at birth and respiratory difficulty were the most commonly associated conditions. Although all infants were ill appearing at or shortly after birth, only one death occurred. In our experience, anaerobic bacteremia in the newborn infant may be self-limited with a favorable prognosis regardless of antimicrobial therapy. Anaerobic pathogens, however, may occasionally be associated with serious perinatal morbidity and mortality. Anaerobic cultures employing special media should be performed routinely in all neonates with suspected sepsis, particularly when aerobic cultures have been negative.