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Diagnosing anaerobic Actinomyces involved in infections
Anaerobic Actinomyces are nonsporeforming, thin branching, gram-positive bacilli that are part of the normal flora of the human oral cavity and may also colonize the gastrointestinal and female genital tracts. Their presence is important in preserving the usual bacterial populations of the mouth and in preventing infection with pathogenic bacteria.
Actinomyces are generally of low pathogenicity but may be an important factor in the development of periodontal disease and may cause soft tissue infections in colonized areas of the body following trauma (surgical or otherwise). The typical lesion consists of an outer zone of granulation around central purulent loculations containing masses of tangled organisms ("sulfur granule"). Chronic burrowing sinus tracts develop. Typical actinomycotic infections occur around the head and neck, in the lung and chest wall, and in the peritoneal cavity and abdominal wall. Actinomycosis of the female genital tract occurs in association with use of intrauterine contraceptive devices. Purulent collections containing "sulfur granules" may drain from some sinus tracts opening to the skin.
Identification of probable pathogens
Isolation of anaerobic Actinomyces in significant numbers from well collected specimens including blood, other normally sterile body fluids, or closed collections of purulent fluid indicates infection with the identified organism.
Specimens should be collected by needle and syringe aspiration or surgical drainage to avoid contamination with normal-flora Actinomyces, especially in and around the oral cavity; such contamination would make interpretation of culture results impossible.
Specimens must be transported in anaerobic transport vials.
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2.. Hall V, Copsey SD: Propionibacterium, Lactobacillus, Actinomyces, and Other Non-Spore-Forming Anaerobic Gram-Positive Rods. In Manual of Clinical Microbiology. 11th edition. Edited by J Jorgensen. Washington DC, ASM Press, 2015 Chapters 52, pp 920-939
3. Morton A, Hall, GS: Anaerobic Gram-Positive Bacilli. In Clinical Microbiology Procedures Handbook. Third edition. Vol. 1. Edited by LS Garcia. Washington DC, ASM Press, 2010