Invasive infections with Fusobacterium necrophorum including Lemierre's syndrome: an 8-year Swedish nationwide retrospective study.
Adolescent
Adult
Age Distribution
Aged
Blood Culture
/ methods
DNA, Bacterial
/ genetics
DNA, Ribosomal
/ genetics
Female
Fusobacterium Infections
/ diagnosis
Fusobacterium necrophorum
/ genetics
Humans
Incidence
Lemierre Syndrome
/ diagnosis
Male
Middle Aged
Mortality
RNA, Ribosomal, 16S
/ genetics
Retrospective Studies
Sepsis
/ epidemiology
Sweden
/ epidemiology
Thrombocytopenia
/ epidemiology
Young Adult
Epidemiology
Fusobacterium necrophorum
Lemierre's syndrome
Necrobacillosis
Sepsis
Septic thrombophlebitis
Journal
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
ISSN: 1469-0691
Titre abrégé: Clin Microbiol Infect
Pays: England
ID NLM: 9516420
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
11
10
2019
revised:
06
12
2019
accepted:
08
12
2019
pubmed:
18
12
2019
medline:
9
2
2021
entrez:
18
12
2019
Statut:
ppublish
Résumé
We aimed to evaluate the nationwide incidence and a potential increase in invasive infections with Fusobacterium necrophorum. Secondly, we aimed to describe epidemiology, clinical characteristics and outcomes for the different presentations: Lemierre's syndrome (LS), invasive head and neck-infection without LS and invasive non-head and neck-infection. A retrospective multicentric population-based study of all invasive infections with F. necrophorum diagnosed in Sweden from 2010 to 2017 with 6 months of follow-up was performed through reviews of medical records. Invasive infections were defined and identified by a positive blood culture or sequencing of 16S rDNA, targeted PCR or culture from normally sterile sites. Incidence calculations were performed, including comparisons between 2010-13 and 2014-17, age groups and clinical presentations. Patient and infection characteristics, treatment and clinical outcomes were analysed. Invasive infections with F. necrophorum were diagnosed in 300 cases in Sweden 2010-17. The incidence increased from 2.9 to 5.0 cases/million/year from 2010-13 to 2014-17 (p 0.001). A total of 104/300 (35%) patients developed LS, 102/300 (34%) invasive head and neck infection without LS and 94/300 (31%) invasive non-head and neck infection. The median age was 20, 25 and 64 years, respectively. Among patients with LS 72/96 (75%) had thrombocytopenia on admission, 86/104 (83%) had sepsis, 19/104 (18%) developed septic shock and 45/104 (43%) needed intensive care. 30-day mortality in LS was 2/104 (2%). We describe an increased incidence of invasive infections with F. necrophorum in Sweden and highlight its full spectrum of invasive clinical presentations. LS, in particular, causes considerable morbidity in young and previously healthy patients.
Identifiants
pubmed: 31843654
pii: S1198-743X(19)30654-8
doi: 10.1016/j.cmi.2019.12.002
pii:
doi:
Substances chimiques
DNA, Bacterial
0
DNA, Ribosomal
0
RNA, Ribosomal, 16S
0
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1089.e7-1089.e12Informations de copyright
Copyright © 2019 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.