Geographical differences in tonsillar carriage rates of Fusobacterium necrophorum – A cross-sectional study in Sweden and Zambia

Nygren, D. R.; Brorson, Ellen; Musonda, Michael; Wasserstrom, Lisa; Johansson, Åsa; Holm, Karin

doi:10.1016/j.anaerobe.2021.102360

Cited by 5 publications

(10 citation statements)

References 24 publications

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“…time period and with consistent sampling technique and concomitant performance of cultivation and PCR. In Table 4, we present our present findings in relation to the findings of prior studies [3,6,11]. Our culture-based detection rate was similar to these studies.…”

Section: Performance Of Real-time Pcr Assayssupporting

confidence: 89%

“…Notably, the PCR results were weakly positive for a majority of these samples, indicating low amounts of GAS and F. necrophorum. Interestingly, Nygren et al noted an even higher rate of PCR-based detection of F. necrophorum than in our study [11].…”

Section: Performance Of Real-time Pcr Assayscontrasting

confidence: 72%

“…Repeated PCR analysis using DNA extracts that were diluted 10-fold and 100-fold revealed GAS in one of these individuals, indicating that this sample was affected by PCR inhibition, while the remaining six samples remained PCR negative. In nine The study of Nygren et al 2021 [11] has two arms with participants in Sweden and Zambia respectively, with the sampling performed in different periods in the two countries. We have only included the part performed in Sweden.…”

Section: Performance Of Real-time Pcr Assaysmentioning

confidence: 99%

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High prevalence of pharyngeal bacterial pathogens among healthy adolescents and young adults

Agerhäll

Henrikson

Söderberg

et al. 2021

APMIS

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The pharyngeal mucosa can be colonized with bacteria that have potential to cause pharyngotonsillitis. By the use of culturing techniques and PCR, we aimed to assess the prevalence of bacterial pharyngeal pathogens among healthy adolescents and young adults. We performed a cross-sectional study in a community-based cohort of 217 healthy individuals between 16 and 25 years of age. Samples were analyzed for Group A streptococci (GAS), Group C/G streptococci (SDSE), Fusobacterium necrophorum, and Arcanobacterium haemolyticum. Compared to culturing, the PCR method resulted in more frequent detection, albeit in most cases with low levels of DNA, of GAS (20/217 vs. 5/217; p < 0.01) and F. necrophorum (20/217 vs. 8/217; p < 0.01). Culturing and PCR yielded similar rates of SDSE detection (14/217 vs. 12/217; p = 0.73). Arcanobacterium haemolyticum was rarely detected (3/217), and only by PCR. Overall, in 25.3% (55/217) of these healthy adolescents and young adults at least one of these pathogens was detected, a rate that is higher than previously described. Further studies are needed before clinical adoption of PCR-based detection methods for pharyngeal bacterial pathogens, as our findings suggest a high incidence of asymptomatic carriage among adolescents and young adults without throat infections.

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Section: Performance Of Real-time Pcr Assayssupporting

confidence: 89%

Section: Performance Of Real-time Pcr Assayscontrasting

confidence: 72%

Section: Performance Of Real-time Pcr Assaysmentioning

confidence: 99%

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High prevalence of pharyngeal bacterial pathogens among healthy adolescents and young adults

Agerhäll

Henrikson

Söderberg

et al. 2021

APMIS

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“…Hospitalization was most commonly seen in patients with GAS infection, while those with F. necrophorum had the highest rates of recurrence of pharyngotonsillitis (15–30 days) ( Table 2 ) and peritonsillar abscess ( Figure 3 ). It can be difficult to interpret a finding of F. necrophorum in pharyngotonsillitis because most cases occur in the same age group where tonsillar carriage is seen [ 11 , 22 ]. We found a test positivity rate of F. necrophorum of 28%, and higher (38%) among patients aged 13–30 years, in line with previous studies [ 8–10 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…The real-time PCR used for F. necrophorum was modified from the methods presented by Jensen et al [ 10 ] and Aliyu et al [ 20 ] and performed as described by Nygren et al [ 11 ]. All samples were analyzed at the Department of Clinical Microbiology at the Skåne University Hospital, Lund, Sweden.…”

Section: Methodsmentioning

confidence: 99%

Associations Between Findings of Fusobacterium necrophorum or β-Hemolytic Streptococci and Complications in Pharyngotonsillitis—A Registry-Based Study in Southern Sweden

Nygren

Wasserstrom

Holm

et al. 2022

Clinical Infectious Diseases

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Background Most pharyngotonsillitis guidelines focus on the identification of group A streptococci (GAS), guided by clinical scores determining whom to test with a rapid antigen detection test (RADT). Nevertheless, many RADT-negative patients are evaluated for Group C/G streptococci (GCS/GGS) and Fusobacterium necrophorum, yet their importance remains debated. Our primary aim was to evaluate associations between complications and findings of F. necrophorum, GAS or GCS/GGS in pharyngotonsillitis. Methods This was a retrospective, registry-based study of pharyngotonsillitis cases tested for F. necrophorum (PCR) and beta-hemolytic streptococci (culture) in the Skåne Region, Sweden 2013-2020. Patients with prior complications or antibiotics (30 days) were excluded. Data were retrieved from registries and electronic charts. Logistic regression analyses were performed with a dichotomous composite outcome of complications as primary outcome, based on ICD-10-codes. Cases with negative results (PCR and culture) were set as reference category. Complications within 30 days were defined as peritonsillar or pharyngeal abscess, otitis, sinusitis, sepsis or septic complications, recurrence of pharyngotonsillitis (after 15-30 days) or hospitalization. Results Of 3700 registered cases, 28% had F. necrophorum, 13% GCS/GGS, 10% GAS and 54% negative results. 30-day complication rates were high (20%). F. necrophorum OR 1.8 (95CI 1.5-2.1) and GAS OR 1.9 (95CI 1.5-2.5) were associated with complications whereas GCS/GGS were negatively associated with complications OR 0.7 (95CI 0.4-0.98). Conclusion Our results indicate F. necrophorum as a relevant pathogen in pharyngotonsillitis, whereas the relevancy of testing for GCS/GGS is questioned. Yet, which patient to test and treat for F. necrophorum remains to be defined.

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Symptoms predictive of Fusobacterium necrophorum pharyngotonsillitis – an observational study of cases presenting to hospitals in Southern Sweden

Pagels,

Torisson,

Wasserstrom

et al. 2024

Eur J Clin Microbiol Infect Dis

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Objectives Fusobacterium necrophorum is a common cause of pharyngotonsillitis. However, no guidelines exist on when to diagnose or treat it. We aimed to investigate associations between clinical criteria and F. necrophorum-positivity in pharyngotonsillitis and assess the predictive potential of a simple scoring system. Methods Pharyngotonsillitis patients who were tested for F. necrophorum (PCR) and presented to hospitals in the Skåne Region, Sweden, between 2013–2020 were eligible. Data were retrieved from electronic chart reviews and registries. By logistic regression we investigated associations between F. necrophorum-positivity and pre-specified criteria: age 13–30 years, symptom duration ≤ 3 days, absence of viral symptoms (e.g. cough, coryza), fever, tonsillar swelling/exudate, lymphadenopathy and CRP ≥ 50 mg/L. In secondary analyses, associated variables were weighted by strength of association into a score and its predictive accuracy of F. necrophorum was assessed. Results Among 561 cases included, 184 (33%) had F. necrophorum, which was associated with the following criteria: age 13–30, symptom duration ≤ 3 days, absence of viral symptoms, tonsillar swelling/exudate and CRP ≥ 50 mg/L. Age 13–30 had the strongest association (OR5.7 95%CI 3.7–8.8). After weighting, these five variables had a sensitivity and specificity of 68% and 71% respectively to predict F. necrophorum-positivity at the proposed cut-off. Conclusion Our results suggest that F. necrophorum cases presenting to hospitals might be better distinguished from other pharyngotonsillitis cases by a simple scoring system presented, with age 13–30 being the strongest predictor for F. necrophorum. Prospective studies, involving primary care settings, are needed to evaluate generalisability of findings beyond cases presenting to hospitals.

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Geographical differences in tonsillar carriage rates of Fusobacterium necrophorum – A cross-sectional study in Sweden and Zambia

Cited by 5 publications

References 24 publications

High prevalence of pharyngeal bacterial pathogens among healthy adolescents and young adults

High prevalence of pharyngeal bacterial pathogens among healthy adolescents and young adults

Associations Between Findings of Fusobacterium necrophorum or β-Hemolytic Streptococci and Complications in Pharyngotonsillitis—A Registry-Based Study in Southern Sweden

Symptoms predictive of Fusobacterium necrophorum pharyngotonsillitis – an observational study of cases presenting to hospitals in Southern Sweden

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