Analysis of the tonsillar microbiome in young adults with sore throat reveals a high relative abundance of Fusobacterium necrophorum with low diversity

Abstract

Fusobacterium necrophorum (Fn), a gram-negative anaerobe, is increasingly implicated as an etiologic agent in older adolescents and young adults with sore throat. Inadequately treated Fn pharyngitis may result in suppurative complications such as peritonsillar abscess and Lemierre’s syndrome. Data from the literature suggest that the incidence of life-threating complications in these age groups from Fn pharyngitis (Lemierre’s syndrome) in the United States exceeds those associated with group A beta-hemolytic streptococcal (GAS) pharyngitis (acute rheumatic fever). Using real-time PCR, we previously reported about a 10% prevalence of Fn in asymptomatic medical students and about 20% in students complaining of sore throat at a university student health clinic (p = 0.009). In this study, a comprehensive microbiome analysis of the same study samples confirms that Fn pharyngitis was more common than GAS pharyngitis. Eighteen patients were found to have Fn OTU values exceeding an arbitrary cutoff value of 0.1, i.e. greater than 10% of total sequences, with five subjects reaching values above 0.7. By contrast only 9 patients had GAS OTU values greater than 0.1 and none exceeded 0.6. When the data were analyzed using five separate assessments of alpha diversity, in each case for Fn there were statistically significant differences between Fn positive_high (OTU abundance > 0.1) vs control, Fn positive_high vs Fn negative (OTU abundance = 0), Fn positive_high vs Fn positive_low (OTU abundance > 0 and < 0.1). When the data were analyzed using three beta diversity indexes (Bray-Curtis, weighted unifrac, and unweighted unifrac), there were statistically significant differences between Fn positive_high (OTU abundance ≥ 0.1) vs control for all three. Statistically significant differences remained if we chose somewhat different OTU abundance cutoffs of 0.05 or 0.15. We conclude that Fn appears to play a dominant role in bacterial pharyngitis in the older adolescent and young adult age groups and that the development of a productive mucosal infection with Fn is linked to a significant decrease in the diversity of the associated tonsillar microbiome.

Differential Susceptibility of Mycoplasma and Ureaplasma Species to Compound-Enhanced Copper Toxicity

“…Additionally, copper can be found in urine as a host effector molecule to decrease bacterial infiltration into the urinary tract (Hyre et al, 2017). Relatedly, mollicutes typically found in the urogenital tract have also been reported in oropharyngeal and respiratory specimens (Waites et al, 2005; Bharat et al, 2015; Tyner et al, 2016; Atkinson et al, 2018). These conflicting findings suggest that the reason(s) for these observed differences in copper-resistance will require further study.…”

Patients with Lemierre syndrome have a high risk of new thromboembolic complications, clinical sequelae and death: an analysis of 712 cases

“…Lemierre syndrome is a life-threatening condition characterized by acute bacterial infection of the head or neck, such as exudative tonsillitis or peritonsillar abscess, local septic vein thrombosis and multiple septic emboli. [1] Fusobacterium necrophorum, a Gram-negative anaerobe highly prevalent in the oropharynx of healthy individuals [2,3] and amongst teenagers with tonsillitis or pharyngitis, [4,5] is frequently involved in the syndrome, which develops only in isolated cases due to the frequent susceptibilityofthispathogentocommonlyusedantibioticssuch as penicillin and other beta-lactams. [6] Bacteriumspecific mechanisms suggested to be involved in the pathogenesis include tropism for vessels, [7] a tendency to cause bacteraemia and increase tissue permeability, [8,9] inhibition of the innate immune response [10,11] and direct activation of the coagulation cascade.…”

What is Dysbiosis and, in which Parts of the Organism Exists?

“…It has been shown that Porphyromonas gingival is can be transferred to the intestine [49]. These and other analyzes [50] conclude the importance of the microbiota, as a whole, in these frequent conditions. Dysbiosis in the Urinary Microbiota.…”