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Epidemiology and Clinical Outcomes of Fusobacterium Infections: A Six-Year Retrospective Study
Akram Khan1, Hamza Alzghoul2, Abdul Ahad Khan3
1Department of Internal Medicine, Oregon Health and Science University, Portland, OR 97239-3098, USA.
Abstract:
Background and Objectives: Anaerobic bacteria like Fusobacterium can lead to severe and life-threatening infections. The inherent complexities in the isolation of these bacteria may result in diagnostic and therapeutic delays, thereby escalating both morbidity and mortality rates. We aimed to examine data from patients with infections due to Fusobacterium to gain insights into the epidemiology and clinical outcomes of patients with these infections. Methods and Results: We conducted a retrospective analysis of clinical data from a cohort of patients with cultures positive for Fusobacterium species at a tertiary care medical center in the United States. Between 2009 and 2015, we identified 96 patients with cultures positive for Fusobacterium. Patients could be categorized into three groups based on the site of primary infection. Patients with head and neck infections constituted 37% (n 36). Patients with infections of other soft tissue sites accounted for 38.5% (n 37). Patients with anaerobic bacteremia due to Fusobacterium formed 24% (n 23) of the cohort. Surgical intervention coupled with antibiotic therapy emerged as cornerstones of management for patients with head and neck or other soft tissue infections, who generally exhibited more favorable outcomes. Patients with bacteremia were older, more likely to have malignancy, and had a high mortality rate. When speciation was available, Fusobacterium necrophorum was the most frequently isolated species. Conclusions: Our retrospective analysis of epidemiology and clinical outcomes of Fusobacterium infections revealed three distinct cohorts. Patients with head, neck, or soft tissue infections had better outcomes than those with bacteremia. Our findings highlight the importance of employing management strategies based on infection site and underlying comorbidities in patients with Fusobacterium infections. Further research is needed to investigate the optimal therapeutic strategies and identify prognostic indicators to improve clinical outcomes for these complex infections.
Insights
Severe infections caused by Fusobacterium bacteria can be life-threatening. This study found that head, neck, and soft tissue infections had better outcomes than bacteremia, highlighting the need for tailored treatment strategies.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Anaerobic bacteria, including Fusobacterium species, are associated with severe, life-threatening infections.
- Difficulties in isolating Fusobacterium can delay diagnosis and treatment, increasing patient morbidity and mortality.
Purpose of the Study:
- To investigate the epidemiology and clinical outcomes of Fusobacterium infections.
- To identify distinct patient cohorts and factors influencing prognosis.
Main Methods:
- Retrospective analysis of clinical data from 96 patients with Fusobacterium-positive cultures (2009-2015).
- Categorization of patients based on primary infection site: head and neck, other soft tissue, or anaerobic bacteremia.
Main Results:
- Head and neck (37%) and soft tissue (38.5%) infections had better outcomes with surgical and antibiotic management.
- Patients with Fusobacterium bacteremia (24%) were older, had higher rates of malignancy, and experienced significantly higher mortality.
- Fusobacterium necrophorum was the most common species identified.
Conclusions:
- Fusobacterium infections present as three distinct clinical cohorts with varying prognoses.
- Head, neck, and soft tissue infections generally yield better outcomes compared to bacteremia.
- Management strategies should be tailored to the infection site and patient comorbidities to improve outcomes for complex Fusobacterium infections.
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