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Prevotella and Porphyromonas infections in children
1Department of Pediatrics, Georgetown University School of Medicine, Washington, DC, USA.
Abstract:
From 1974 to 1994, 504 isolates of Prevotella and Porphyromonas spp. were obtained from 435 (21%) of 2033 specimens from 418 children. They included 160 (32%) Pr. melaninogenica, 105 (21%) Pr. intermedia, 84 (17%) P. asaccharolytica, 58 (12%) Pr. orisbuccae, and 58 (12%) Pr. oralis. Most Prevotella and Porphyromonas spp. were isolated from abscesses (176), pulmonary infections (85), ear infections (82), wound infections (44), peritonitis (38), paronychia (15) and chronic sinusitis (14). Predisposing conditions were noted in 111 (27%) of the cases; these included previous surgery in 41 (10%), foreign body in 36 (9%), neurological deficiencies in 29 (7%), immunodeficiency in 21 (5%), steroid therapy in 12 (4%), diabetes in 8 (2%) and malignancy in 7 (2%). Prevotella and Porphyromonas spp. were the only isolates in 14 (3%) patients, and mixed infection was encountered in 404 (97%). The micro-organisms most commonly isolated with Prevotella and Porphyromonas spp. were anaerobic cocci (393 isolates), Fusobacterium spp. (108), Bacteroides spp. (B. fragilis group) (95), Escherichia coli (56) and other gram-negative anaerobic bacilli (52). Most Bacteroides spp. and E. coli were isolated from intra-abdominal infections and skin and soft tissue infections around the rectal area, whereas most Fusobacterium spp. were isolated from oropharyngeal, pulmonary and head and neck sites. beta-Lactamase production was detected in 191 (38%) Prevotella and Porphyromonas isolates from all body sites. All patients received antimicrobial therapy, and surgical drainage was performed in 173 (41%) cases. Four patients died from their infection. These data illustrate the spectrum and importance of Prevotella and Porphyromonas spp. in infections in children.
Insights
Prevotella and Porphyromonas species are significant causes of pediatric infections, often occurring in mixed infections. Understanding their prevalence and associated conditions is crucial for effective treatment and management in children.
Area of Science:
- Medical Microbiology
- Pediatric Infectious Diseases
Background:
- Prevotella and Porphyromonas species are anaerobic bacteria commonly found in the human oral cavity.
- These bacteria have been implicated in various human infections, but their role in pediatric infections requires further elucidation.
Purpose of the Study:
- To investigate the prevalence and clinical significance of Prevotella and Porphyromonas species in pediatric infections.
- To identify common infection sites, predisposing conditions, and co-infecting microorganisms associated with these bacteria in children.
Main Methods:
- Retrospective analysis of bacterial isolates from pediatric specimens collected between 1974 and 1994.
- Identification and species-level characterization of Prevotella and Porphyromonas isolates.
- Correlation of bacterial findings with clinical data, including infection sites, patient history, and outcomes.
Main Results:
- Prevotella and Porphyromonas species were isolated from 21% of pediatric specimens, with Prevotella melaninogenica being the most common species.
- Abscesses, pulmonary infections, and ear infections were the most frequent sites.
- Predisposing conditions such as previous surgery and foreign bodies were noted in 27% of cases. Mixed infections were common (97%), frequently involving anaerobic cocci and Fusobacterium species.
- Beta-lactamase production was detected in 38% of isolates.
Conclusions:
- Prevotella and Porphyromonas species are significant pathogens in pediatric infections, contributing to a wide spectrum of diseases.
- The high rate of mixed infections underscores the importance of comprehensive microbiological evaluation and broad-spectrum antimicrobial therapy.
- Effective management often requires antimicrobial therapy combined with surgical intervention.