To assess the status of clinical anaerobic bacteriology in the United
States, we surveyed (by means of a questionnaire) 120 hospitals select
ed at random with bed capacities of 200-1000, and we received response
s from 78 (65%), all of which performed some degree of clinical anaero
bic microbiology. Separate anaerobic blood culture bottles were used b
y 73 labs (94%) (median, 450 specimens/mo): 56% used Bactec 7, 27 or 3
7; 15% used 'BacT-Altert'; 11% used Columbia broth; 5% used thioglycol
ate and 'lytic'; 3% each used, Dupont Isolator, Supplemented peptone o
r other media. Selective media was used for primary anaerobe isolation
by 89% labs which included: LKV, 76%; PEA, 53%; BBE, 31%; CNA, 28%; '
CDC', 12%. Sixty labs (78%) stored anaerobes after isolation (median 7
days), most using blood agar plates (31%), chopped meat (26%) or thio
glycolate broth (27%) either for further identification (30 out of 78)
or susceptibility testing (33 out of 78), if clinically indicated. On
ly 23% performed routine anaerobic susceptibility testing of clinical
isolates. Of the 77% that do not perform susceptibility studies, 59% w
ould not even perform them upon physician request; 30% relied on publi
shed surveys; 68% did not publish results of anaerobic susceptibility
in annual summaries. When susceptibility testing was performed, the te
st agents selected were related to availability on a commercial system
(21), NCCLS recommendation (20), hospital formulary (15) or hospital
committee input (20). Nine of 78 labs (12%) had discussed stopping or
decreasing the performance of both anaerobic bacteriology and suscepti
bility testing. Despite educational and published guidelines, clinical
anaerobic bacteriology is not uniformly practiced and could be improv
ed. In addition, an educational effort must be made in order to stress
the relevance and increase performance of anaerobic bacteriology. (C)
1995 Academic Press