Epidemiology and Clinical Outcomes of Fusobacterium Infections: A Six-Year Retrospective Study

Author:

Khan Akram1ORCID,Alzghoul Hamza2ORCID,Khan Abdul Ahad3,Allada Gopal1,Gronquist Juliann M.4,Pak Jonathan1,Mukundan Srini5,Zakhary Bishoy1ORCID,Wusirika Raghav1,Sher Nehan3,Reddy Raju1

Affiliation:

1. Department of Internal Medicine, Oregon Health and Science University, Portland, OR 97239-3098, USA

2. Graduate Medical Education, College of Medicine, University of Central Florida, Orlando, FL 32827, USA

3. Division of Pulmonary, Critical Care and Sleep Medicine, Banner University Medical Center, College of Medicine-Phoenix, University of Arizona, Phoenix, AZ 85721, USA

4. Department of Nursing, Mirabella Portland, Portland, OR 97239, USA

5. Knight Cardiovascular Institute, 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.

Funder

National Center for Advancing Translational Sciences (NCATS), National Institutes of Health

Publisher

MDPI AG

Subject

General Medicine

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