Incidence, risk factors, and outcomes of Fusobacterium species bacteremia

Abstract

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.

A primary canine and an impacted permanent canine with infection potentially induced an intracranial abscess

“…F. necrophorum bacteraemia has occurred in a younger population without underlying comorbidities and was not associated with mortality. On the other hand, F. nucleatum bacteraemia was found in an older population and was associated with underlying malignancy or dialysis treatment . Although F. necrophorum is dominant in this patient’s age group, we did not detect the species, possibly due to the limitation of the bacterial detection method used.…”

“…from the patient’s peripheral blood led to the detection of the causative focus in the oral cavity and the choice of effective antibiotics (benzylpenicillin potassium) for a central nervous system infection. Afra et al . revealed that F. nucleatum was the most frequently detected species followed by F. necrophorum in Fusobacterium spp.…”

Anaerobic Spondylodiscitis due toFusobacteriumSpecies: A Case Report Review of the Literature

“…Fusobacterial infections of almost every anatomic site have been reported [23, 24]. Bacteremia caused by Fusobacterium species is unusual but not rare [25–27]. Several patients with fusobacterial vertebral and paravertebral infections without classic spondylodiscitis have also been reported [28–31].…”

Empiema por Fusobacterium necrophorum

“…Otra especie del género fusobacterium, el F. nucleatum, forma parte de la flora orofaríngea y juega un papel crucial en la enfermedad periodontal. A semejanza del F. necrophorum, la diseminación de la infección puede alcanzar cerebro, hígado, articulaciones y válvulas cardíacas 11 , no obstante, el F. nucleatum es uno de los anaerobios que con más frecuencia se aisla en los empiemas pleurales. El F. necrophorum afecta más a jóvenes y adultos sanos, sin embargo la población afectada por el F. nucleatum es de mayor edad y presenta comorbilidades, como insuficiencia renal en hemodiálisis o neoplasias 11 .…”

“…A semejanza del F. necrophorum, la diseminación de la infección puede alcanzar cerebro, hígado, articulaciones y válvulas cardíacas 11 , no obstante, el F. nucleatum es uno de los anaerobios que con más frecuencia se aisla en los empiemas pleurales. El F. necrophorum afecta más a jóvenes y adultos sanos, sin embargo la población afectada por el F. nucleatum es de mayor edad y presenta comorbilidades, como insuficiencia renal en hemodiálisis o neoplasias 11 . Las infecciones por F. necrophorum requieren un tratamiento antibiótlico prolongado, así como drenaje de las colecciones 2 .…”