Yusuf Erlangga, Halewyck Stijn, Wybo Ingrid, Piérard Denis, Gordts Frans
Department of Medical Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Brussels, Belgium.
Department of Ear, Nose, and Throat, Universitair Ziekenhuis Brussel, Brussels, Belgium.
Anaerobe. 2015 Aug;34:120-4. doi: 10.1016/j.anaerobe.2015.05.006. Epub 2015 May 16.
Fusobacterium spp. from clinical specimens are increasingly reported. We sought to describe the epidemiology, the microbiological, and the clinical characteristics of head and neck infections caused by Fusobacterium necrophorum and other Fusobacterium spp.
Retrospective cohort study between October 1st, 2004 and September 30(th), 2014 performed in an academic hospital. Electronic patient charts and the laboratory information system were reviewed for demographic and microbiological data. The number and percentages of specific diagnosis and treatment among patients with positive Fusobacterium spp. culture were calculated. The incidence was calculated based on the number of specimens investigated each year.
Included were 230 cultures of 230 patients (median age of 28 years, 61.7% men). F. necrophorum was often found in young patients with high C-reactive protein (CRP) and high number of leukocytes in blood. Other Fusobacterium spp. were often found in middle aged patients with relatively high CRP and slightly increased leukocytes. Three major causes of the isolation of F. necrophorum and other Fusobacterium spp. were acute tonsillitis (n = 18, incidence of 0.2%), peritonsillar abscess (n = 39, 0.5%) and acute otitis (n = 45, 0.1%). While F. necrophorum was found in majority (37/57) of patients with acute tonsillitis or peritonsillar abscess, Fusobacterium spp. other than F. necrophorum were found in the majority (35/45) of patients with acute otitis. Isolated fusobacteria were susceptible to beta-lactam antibiotics, clindamycin and metronidazole. The outcomes of patients with Fusobacterium spp. were good.
F. necrophorum and other Fusobacterium spp. are rare cause of head and neck infections. The infections are well treated by combination of antibiotics and surgery.
临床标本中坏死梭杆菌的报道日益增多。我们试图描述由坏死梭杆菌和其他梭杆菌属引起的头颈部感染的流行病学、微生物学及临床特征。
于2004年10月1日至2014年9月30日在一家教学医院开展回顾性队列研究。查阅电子病历和实验室信息系统以获取人口统计学和微生物学数据。计算梭杆菌属培养阳性患者中特定诊断和治疗的数量及百分比。发病率根据每年检测的标本数量计算。
纳入230例患者的230份培养物（中位年龄28岁，男性占61.7%）。坏死梭杆菌常见于C反应蛋白（CRP）高且血液中白细胞数量多的年轻患者。其他梭杆菌属常见于CRP相对较高且白细胞略有增多的中年患者。坏死梭杆菌和其他梭杆菌属分离的三大主要原因是急性扁桃体炎（n = 18，发病率0.2%）、扁桃体周脓肿（n = 39，0.5%）和急性中耳炎（n = 45，0.1%）。在大多数急性扁桃体炎或扁桃体周脓肿患者（37/57）中发现坏死梭杆菌，而在大多数急性中耳炎患者（35/45）中发现非坏死梭杆菌属的梭杆菌。分离出的梭杆菌对β-内酰胺类抗生素、克林霉素和甲硝唑敏感。梭杆菌属感染患者的预后良好。
坏死梭杆菌和其他梭杆菌属是头颈部感染的罕见病因。通过抗生素与手术联合治疗，感染可得到良好控制。
