PDF(Pubmed)
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.
摘要：
背景与目的：厌氧菌如梭杆菌属可导致严重且危及生命的感染。分离这些细菌的内在复杂性可能导致诊断和治疗延迟。从而提高发病率和死亡率。我们的目的是检查患者感染的数据，以了解这些感染患者的流行病学和临床结果。方法和结果：我们对美国三级医疗中心梭菌培养阳性患者的临床数据进行了回顾性分析。在2009年至2015年之间，我们确定了96例梭杆菌培养阳性的患者。根据原发感染的部位，可以将患者分为三组。头颈部感染患者占37%（n36）。其他软组织部位感染的患者占38.5％（n37）。由于梭杆菌引起的厌氧菌血症患者占队列的24％（n23）。手术干预加上抗生素治疗成为头颈部或其他软组织感染患者管理的基石。他们通常表现出更有利的结果。菌血症患者年龄较大，更有可能患有恶性肿瘤，死亡率很高。当物种形成可用时，坏死梭杆菌是最常见的分离物种。结论：我们对梭杆菌感染的流行病学和临床结果的回顾性分析显示了三个不同的队列。头部患者,脖子,或软组织感染的结局优于菌血症患者.我们的发现强调了在梭菌感染患者中采用基于感染部位和潜在合并症的管理策略的重要性。需要进一步的研究来研究最佳治疗策略并确定预后指标以改善这些复杂感染的临床结果。
