Bad news itself or just the messenger? The high mortality of Fusobacterium spp. infections is related to disseminated malignancy and other comorbidities

Katrine Johannesen, Ram Benny Dessau, Ole Heltberg, Uffe Bodtger

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Abstract

Background Fusobacterium species are pleomorphic, obligate anaerobic gram-negative bacilli. They are difficult to culture and grow slowly. If antibiotic treatment is initiated prior to blood cultures, the bacteria might evade detection. This is a comprehensive report on mortality in non-bacteraemia fusobacterial infection. Methods Data were collected retrospectively in adults having a positive culture with Fusobacterium spp. admitted during 2000–2012 at the medical department. Data on culture specimens, number of cultures, admission and culture dates, patient age, gender, clinical disease, Charlson's index of co-morbidity, CRP level and survival were obtained. For comparison, we traced 60 consecutive, similarly obtained cultures from 2009 to 2010 containing Staphylococcus aureus. Results Within a 12-year period, we identified 28 patients with a positive culture of Fusobacterium spp. in a medical ward serving a population of 220,000. Only a minority (39%) had a positive blood culture, and 54% had focus in respiratory tract or pleura. Overall 6-month mortality was 32%, and unrelated to subspecies, treatment or anatomic location but significantly related to age >60 years, admission for severe, acute illness, and comorbidity, especially metastatic malignancy. Comparison between infection with Fusobacterium spp. and S. aureus showed that Fusobacterium spp. infections were predominantly community acquired, while S. aureus were both community and hospital acquired. Overall mortality for both bacterial infections increased significantly with age and current malignant disease. S. aureus–infected patients carried a significantly higher mortality.
Original languageEnglish
Article number30287
JournalEuropean Clinical Respiratory Journal
Volume3
Number of pages6
ISSN2001-8525
DOIs
Publication statusPublished - 10. May 2016

Keywords

  • Fusobacterium necrophorum
  • Fusobacterium nucleatum
  • mortality
  • Admission
  • Cancer
  • Multimorbidity

Cite this

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title = "Bad news itself or just the messenger? The high mortality of Fusobacterium spp. infections is related to disseminated malignancy and other comorbidities",
abstract = "Background Fusobacterium species are pleomorphic, obligate anaerobic gram-negative bacilli. They are difficult to culture and grow slowly. If antibiotic treatment is initiated prior to blood cultures, the bacteria might evade detection. This is a comprehensive report on mortality in non-bacteraemia fusobacterial infection. Methods Data were collected retrospectively in adults having a positive culture with Fusobacterium spp. admitted during 2000–2012 at the medical department. Data on culture specimens, number of cultures, admission and culture dates, patient age, gender, clinical disease, Charlson's index of co-morbidity, CRP level and survival were obtained. For comparison, we traced 60 consecutive, similarly obtained cultures from 2009 to 2010 containing Staphylococcus aureus. Results Within a 12-year period, we identified 28 patients with a positive culture of Fusobacterium spp. in a medical ward serving a population of 220,000. Only a minority (39{\%}) had a positive blood culture, and 54{\%} had focus in respiratory tract or pleura. Overall 6-month mortality was 32{\%}, and unrelated to subspecies, treatment or anatomic location but significantly related to age >60 years, admission for severe, acute illness, and comorbidity, especially metastatic malignancy. Comparison between infection with Fusobacterium spp. and S. aureus showed that Fusobacterium spp. infections were predominantly community acquired, while S. aureus were both community and hospital acquired. Overall mortality for both bacterial infections increased significantly with age and current malignant disease. S. aureus–infected patients carried a significantly higher mortality.",
keywords = "Fusobacterium necrophorum, Fusobacterium nucleatum, mortality, Admission, Cancer, Multimorbidity",
author = "Katrine Johannesen and Dessau, {Ram Benny} and Ole Heltberg and Uffe Bodtger",
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doi = "10.3402/ecrj.v3.30287",
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Bad news itself or just the messenger? The high mortality of Fusobacterium spp. infections is related to disseminated malignancy and other comorbidities. / Johannesen, Katrine ; Dessau, Ram Benny; Heltberg, Ole; Bodtger, Uffe.

In: European Clinical Respiratory Journal, Vol. 3, 30287, 10.05.2016.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Bad news itself or just the messenger? The high mortality of Fusobacterium spp. infections is related to disseminated malignancy and other comorbidities

AU - Johannesen, Katrine

AU - Dessau, Ram Benny

AU - Heltberg, Ole

AU - Bodtger, Uffe

PY - 2016/5/10

Y1 - 2016/5/10

N2 - Background Fusobacterium species are pleomorphic, obligate anaerobic gram-negative bacilli. They are difficult to culture and grow slowly. If antibiotic treatment is initiated prior to blood cultures, the bacteria might evade detection. This is a comprehensive report on mortality in non-bacteraemia fusobacterial infection. Methods Data were collected retrospectively in adults having a positive culture with Fusobacterium spp. admitted during 2000–2012 at the medical department. Data on culture specimens, number of cultures, admission and culture dates, patient age, gender, clinical disease, Charlson's index of co-morbidity, CRP level and survival were obtained. For comparison, we traced 60 consecutive, similarly obtained cultures from 2009 to 2010 containing Staphylococcus aureus. Results Within a 12-year period, we identified 28 patients with a positive culture of Fusobacterium spp. in a medical ward serving a population of 220,000. Only a minority (39%) had a positive blood culture, and 54% had focus in respiratory tract or pleura. Overall 6-month mortality was 32%, and unrelated to subspecies, treatment or anatomic location but significantly related to age >60 years, admission for severe, acute illness, and comorbidity, especially metastatic malignancy. Comparison between infection with Fusobacterium spp. and S. aureus showed that Fusobacterium spp. infections were predominantly community acquired, while S. aureus were both community and hospital acquired. Overall mortality for both bacterial infections increased significantly with age and current malignant disease. S. aureus–infected patients carried a significantly higher mortality.

AB - Background Fusobacterium species are pleomorphic, obligate anaerobic gram-negative bacilli. They are difficult to culture and grow slowly. If antibiotic treatment is initiated prior to blood cultures, the bacteria might evade detection. This is a comprehensive report on mortality in non-bacteraemia fusobacterial infection. Methods Data were collected retrospectively in adults having a positive culture with Fusobacterium spp. admitted during 2000–2012 at the medical department. Data on culture specimens, number of cultures, admission and culture dates, patient age, gender, clinical disease, Charlson's index of co-morbidity, CRP level and survival were obtained. For comparison, we traced 60 consecutive, similarly obtained cultures from 2009 to 2010 containing Staphylococcus aureus. Results Within a 12-year period, we identified 28 patients with a positive culture of Fusobacterium spp. in a medical ward serving a population of 220,000. Only a minority (39%) had a positive blood culture, and 54% had focus in respiratory tract or pleura. Overall 6-month mortality was 32%, and unrelated to subspecies, treatment or anatomic location but significantly related to age >60 years, admission for severe, acute illness, and comorbidity, especially metastatic malignancy. Comparison between infection with Fusobacterium spp. and S. aureus showed that Fusobacterium spp. infections were predominantly community acquired, while S. aureus were both community and hospital acquired. Overall mortality for both bacterial infections increased significantly with age and current malignant disease. S. aureus–infected patients carried a significantly higher mortality.

KW - Fusobacterium necrophorum

KW - Fusobacterium nucleatum

KW - mortality

KW - Admission

KW - Cancer

KW - Multimorbidity

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SN - 2001-8525

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