Epidemiological characteristics of infections caused by Bacteroides, Prevotella and Fusobacterium species: A prospective observational study

BackgroundFusobacterium species (spp.) bacteremia is uncommon and has been associated with a variety of clinical presentations. We conducted a retrospective, population based study to determine the relative proportion of species in this genus causing bacteremia and the risk factors for infection and adverse clinical outcomes.MethodsAll cases of Fusobacterium spp. bacteremia detected at a regional microbiology laboratory serving outpatient and acute care for a population of approximately 1.3 million people over 11 years were identified from a computerized database. Clinical data on these cases was extracted from an administrative database and analyzed to determine underlying risk factors for and outcomes of infection.ResultsThere were 72 incident cases of Fusobacterium spp. bacteremia over the study period (0.55 cases/100,000 population per annum). F. nucleatum was the most frequent species (61%), followed by F. necrophorum (25%). F. necrophorum bacteremia occurred in a younger population without underlying comorbidities and was not associated with mortality. F. nucleatum bacteremia was found in an older population and was associated with underlying malignancy or receiving dialysis. Death occurred in approximately 10% of F. nucleatum cases but causality was not established in this study.ConclusionsFusobacterium spp. bacteremia in our community is uncommon and occurs in approximately 5.5 cases per million population per annum. F. necrophorum occurred in an otherwise young healthy population and was not associated with any mortality. F. nucleatum was found primarily in older patients with chronic medical conditions and was associated with a mortality of approximately 10%. Bacteremias from other Fusobacterium spp. were rare.

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“…Penicillin resistance was present for both F. nucleatum and F. necrophorum, but at low levels. This is in keeping with other studies [25,30]. …”

Section: Discussionsupporting

confidence: 94%

Incidence, risk factors, and outcomes of Fusobacterium species bacteremia

et al. 2013

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“…6 Among more than 20 species of the genus, B. fragilis is most frequently isolated from clinical specimens, followed by B. ovatus and B. thetaiotaomicron. 6,16,17 Enterotoxigenic Bacteroides fragilis (ETBF; a sub-group of B. fragilis) has also been implicated in inflammatory bowel disease (IBD) 18,19 and colon cancer. 20 Recently, a 5 y study in Japan revealed that Bacteroides bacteremia was the primary cause of colorectal carcinoma in a group of patients.…”

Section: Introductionmentioning

confidence: 99%

Mobile genetic elements in the genus Bacteroides, and their mechanism(s) of dissemination

Nguyen

Vedantam

2011

Mobile Genetic Elements

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“…This fact, in association with a decreased host response to infection due to granulocytopenia and impaired cellular immunity, may contribute to bloodstream infection caused by bacterial translocation [2]. Despite its low incidence, anaerobic bacteremia is usually associated with high morbidity and mortality rates, especially in the context of cancer and immunosuppression [3–5]. …”

Section: Resultsmentioning

confidence: 99%

Comparison of anti-anaerobic antimicrobial strategies in cancer patients with febrile neutropenia and gastrointestinal symptoms

2014

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BackgroundThe current study sought to compare 28-day mortality rates in cancer patients with febrile neutropenia (FN) and gastrointestinal (GI) symptoms who underwent monotherapy using an antibiotic with antipseudomonal and anti-anaerobic activity (piperacillin-tazobactam or a carbapenem) and a group treated with a combination of cefepime-metronidazole.FindingsWe performed a prospective cohort study in a single tertiary hospital from October 2009 to August 2011. All consecutive adult cancer patients admitted with FN secondary to intensive chemotherapy and GI symptoms (abdominal pain, diarrhea or perianal pain) were evaluated. Kaplan-Meier curves were used for calculating time-dependent occurence of death. In total, 37 patients with FN and GI symptoms were evaluated (15 in monotherapy arm and 22 in the combination therapy arm). Treatment with combination cefepime and metronidazole resulted in a lower 28-day mortality rate compared with piperacillin-tazobactam or carbapenem monotherapy (0% versus 40%; log-rank P=0.002).ConclusionsResults of the present study suggest a significant reduction in mortality in cancer patients with FN and GI symptoms treated with combination cefepime-metronidazole therapy compared with monotherapy using agents with antipseudomonal and anti-anaerobic activity. Further randomized trials are warranted to confirm the superior results using combination therapy in patients with FN and GI symptoms.

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Epidemiological characteristics of infections caused by Bacteroides, Prevotella and Fusobacterium species: A prospective observational study

Cited by 32 publications

References 18 publications

Incidence, risk factors, and outcomes of Fusobacterium species bacteremia

Incidence, risk factors, and outcomes of Fusobacterium species bacteremia

Mobile genetic elements in the genus Bacteroides, and their mechanism(s) of dissemination

Comparison of anti-anaerobic antimicrobial strategies in cancer patients with febrile neutropenia and gastrointestinal symptoms

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