Pett E, Saeed K, Dryden M
Royal Hampshire County Hospital, Hampshire Hospitals NHS Foundation Trust, Romsey Rd, Winchester, Hampshire, UK,
Infection. 2014 Apr;42(2):363-70. doi: 10.1007/s15010-013-0564-2. Epub 2013 Dec 11.
Fusobacterium species infections are rare. Recently, however, this potentially deadly pathogen has been attracting interest, and efforts are being made to characterise its epidemiology and clinical spectrum of disease. The aim of our study is to provide further evidence towards this cause, in what is, to date, the largest study of its kind from the UK.
A 22-year, retrospective, descriptive study was performed at Royal Hampshire County Hospital. An electronic database was used to identify patients with microbiologically confirmed infection with Fusobacterium, and clinical records were examined to provide further information on the presentation, source, treatment and outcome.
Fusobacterium species infections were identified in 18 patients during the study period, which is an incidence of 0.76 cases/100,000/year. The overall death rate was 29 %. Half of these patients had Fusobacterium necrophorum infections and were a predominantly young, fit and uniquely male population who had excellent outcomes. Among the remaining patients with Fusobacterium species infections, 22 % had infection with F. varium and 11 % with F. nucleatum. These patients were an older cohort who tended to have co-morbidities and unsurprisingly worse outcomes. We identified a number of Fusobacterium bacteraemias likely to have resulted from pressure ulcers, a presentation that has been rarely reported. Interestingly, we also identified a case of neonatal F. nucleatum bacteraemia that was not associated with premature nor stillborn birth.
As work continues to depict the spectrum of disease caused by this enigmatic bacterium, it is hoped that improved clinical suspicion will result in better outcomes and management.
梭杆菌属感染较为罕见。然而，近来这种具有潜在致命性的病原体引起了人们的关注，目前正在努力对其流行病学特征和疾病临床谱进行描述。我们这项研究的目的是为这一目标提供进一步的证据，这也是迄今为止英国同类研究中规模最大的一项。
在皇家汉普郡医院开展了一项为期22年的回顾性描述性研究。利用电子数据库识别微生物学确诊的梭杆菌感染患者，并查阅临床记录以获取有关临床表现、感染源、治疗及转归的更多信息。
研究期间共识别出18例梭杆菌属感染患者，发病率为0.76例/10万/年。总体死亡率为29%。这些患者中有一半为坏死梭杆菌感染，主要是年轻、健康的男性，治疗效果良好。在其余梭杆菌属感染患者中，22%为可变梭杆菌感染，11%为具核梭杆菌感染。这些患者年龄较大，往往伴有合并症，治疗效果较差也在意料之中。我们发现一些梭杆菌血症可能由压疮引起，这种情况鲜有报道。有趣的是，我们还发现了1例新生儿具核梭杆菌血症，该病例与早产或死产均无关。
随着对这种神秘细菌所引起疾病谱的研究不断深入，希望临床怀疑指数的提高将带来更好的治疗效果和管理。
