Significance of encapsulated Bacteroides melaninogenicus and Bacteroides fragilis groups in mixed infections.

Organisms of the Bacteroides melaninogenicus and Bacteroides fragilis groups are often found mixed with facultatively anaerobic organisms in infections. The relative importance of these Bacteroides groups and facultative anaerobic pathogens in mixed infections was investigated in a subcutaneous abscess model in mice. This was determined by observing the effect of antimicrobial therapy directed against one or both organisms present in the abscess. Clindamycin or metronidazole was used for treatment of infections caused by Bacteroides species, and either gentamicin, penicillin, ampicillin, or oxacillin was used for treatment of infections caused by facultative flora. In almost all instances the aerobic counterparts in the infection were more important than the unencapsulated Bacteroides species. On the other hand, encapsulated B. melaninogenicus group organisms were found to be more important in abscess formation than were group A streptococci, Streptococcus pneumoniae, Klebsiella pneumoniae, Haemophilus influenzae, and Staphylococcus aureus. Encapsulated B. fragilis group organisms were found to be more important than or as important as Escherichia coli and group D streptococci and less important than S. aureus, group A streptococci, and K. pneumoniae in induction of subcutaneous abscesses. This study demonstrates that encapsulated Bacteroides species are a factor that should be considered in the treatment of mixed infections with antibiotics.