Microbiology of parapharyngeal abscesses in adults: in search of the significant pathogens

Tejs Ehlers Klug; Thomas Greve; Camilla Andersen; Pernille Hahn; Christian Danstrup; Niels Krintel Petersen; Mirjana Ninn-Pedersen; Sophie Mikkelsen; Søren Pauli; Simon Fuglsang; Helle Døssing; Anne-Louise Christensen; Maria Rusan; Anette Kjeldsen

doi:10.1007/s10096-021-04180-y

Microbiology of parapharyngeal abscesses in adults: in search of the significant pathogens

Tejs Ehlers Klug^*, Thomas Greve, Camilla Andersen, Pernille Hahn, Christian Danstrup, Niels Krintel Petersen, Mirjana Ninn-Pedersen, Sophie Mikkelsen, Søren Pauli, Simon Fuglsang, Helle Døssing, Anne-Louise Christensen, Maria Rusan, Anette Kjeldsen

^*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

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Abstract

We aimed to describe the microbiology of parapharyngeal abscess (PPA) and point out the likely pathogens using the following principles to suggest pathogenic significance: (1) frequent recovery, (2) abundant growth, (3) growth in relative abundance to other microorganisms, (4) percentage of the isolates recovered in both absolute and relative abundance, (5) more frequent recovery in PPA pus compared with tonsillar surface and tissue. Comprehensive bacterial cultures were performed on specimens obtained from adult patients (n = 60) with surgically verified PPA, who were prospectively enrolled at five Danish ear-nose-throat departments. The prevalent isolates (in PPA pus) were unspecified anaerobes (73%), non-hemolytic streptococci (67%), Streptococcus anginosus group (SAG) (40%), Corynebacterium spp. (25%), Neisseria spp. (23%), Fusobacterium spp. (22%), Fusobacterium necrophorum (17%), Prevotella spp. (12%), and Streptococcus pyogenes (10%). The bacteria most frequently isolated in heavy (maximum) growth were unspecified anaerobes (60%), SAG (40%), F. necrophorum (23%), and Prevotella spp. (17%). The predominant microorganisms (those found in highest relative abundance) were unspecified anaerobes (53%), SAG (28%), non-hemolytic streptococci (25%), F. necrophorum (15%), S. pyogenes (10%), and Prevotella spp. (10%). Four potential pathogens were found in both heavy growth and highest relative abundance in at least 50% of cases: F. necrophorum, Prevotella spp., SAG, and S. pyogenes. SAG, Prevotella spp., F. necrophorum, S. pyogenes, and Bacteroides spp. were recovered with the same or higher frequency from PPA pus compared with tonsillar tissue and surface. Our findings suggest that SAG, F. necrophorum, Prevotella, and S. pyogenes are significant pathogens in PPA development.

Originalsprog	Engelsk
Tidsskrift	European Journal of Clinical Microbiology & Infectious Diseases
Vol/bind	40
Nummer	7
Sider (fra-til)	1461-1470
Antal sider	10
ISSN	0934-9723
DOI	https://doi.org/10.1007/s10096-021-04180-y
Status	Udgivet - jul. 2021

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10.1007/s10096-021-04180-yLicens: CC BY

Klug2021_Article_MicrobiologyOfParapharyngealAbForlagets udgivne version, 296 KBLicens: CC BY

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Klug, T. E., Greve, T., Andersen, C., Hahn, P., Danstrup, C., Petersen, N. K., Ninn-Pedersen, M., Mikkelsen, S., Pauli, S., Fuglsang, S., Døssing, H., Christensen, A.-L., Rusan, M., & Kjeldsen, A. (2021). Microbiology of parapharyngeal abscesses in adults: in search of the significant pathogens. European Journal of Clinical Microbiology & Infectious Diseases, 40(7), 1461-1470. https://doi.org/10.1007/s10096-021-04180-y

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title = "Microbiology of parapharyngeal abscesses in adults: in search of the significant pathogens",

abstract = "We aimed to describe the microbiology of parapharyngeal abscess (PPA) and point out the likely pathogens using the following principles to suggest pathogenic significance: (1) frequent recovery, (2) abundant growth, (3) growth in relative abundance to other microorganisms, (4) percentage of the isolates recovered in both absolute and relative abundance, (5) more frequent recovery in PPA pus compared with tonsillar surface and tissue. Comprehensive bacterial cultures were performed on specimens obtained from adult patients (n = 60) with surgically verified PPA, who were prospectively enrolled at five Danish ear-nose-throat departments. The prevalent isolates (in PPA pus) were unspecified anaerobes (73%), non-hemolytic streptococci (67%), Streptococcus anginosus group (SAG) (40%), Corynebacterium spp. (25%), Neisseria spp. (23%), Fusobacterium spp. (22%), Fusobacterium necrophorum (17%), Prevotella spp. (12%), and Streptococcus pyogenes (10%). The bacteria most frequently isolated in heavy (maximum) growth were unspecified anaerobes (60%), SAG (40%), F. necrophorum (23%), and Prevotella spp. (17%). The predominant microorganisms (those found in highest relative abundance) were unspecified anaerobes (53%), SAG (28%), non-hemolytic streptococci (25%), F. necrophorum (15%), S. pyogenes (10%), and Prevotella spp. (10%). Four potential pathogens were found in both heavy growth and highest relative abundance in at least 50% of cases: F. necrophorum, Prevotella spp., SAG, and S. pyogenes. SAG, Prevotella spp., F. necrophorum, S. pyogenes, and Bacteroides spp. were recovered with the same or higher frequency from PPA pus compared with tonsillar tissue and surface. Our findings suggest that SAG, F. necrophorum, Prevotella, and S. pyogenes are significant pathogens in PPA development.",

keywords = "Fusobacterium, Microbiology, Parapharyngeal abscess, Pathogens, Streptococcus, Bacteria/classification, Humans, Middle Aged, Male, Young Adult, Adolescent, Aged, 80 and over, Adult, Female, Parapharyngeal Space/microbiology, Aged, Abscess/microbiology",

author = "Klug, {Tejs Ehlers} and Thomas Greve and Camilla Andersen and Pernille Hahn and Christian Danstrup and Petersen, {Niels Krintel} and Mirjana Ninn-Pedersen and Sophie Mikkelsen and S{\o}ren Pauli and Simon Fuglsang and Helle D{\o}ssing and Anne-Louise Christensen and Maria Rusan and Anette Kjeldsen",

year = "2021",

month = jul,

doi = "10.1007/s10096-021-04180-y",

language = "English",

volume = "40",

pages = "1461--1470",

journal = "European Journal of Clinical Microbiology & Infectious Diseases",

issn = "0934-9723",

publisher = "Springer",

number = "7",

}

Klug, TE, Greve, T, Andersen, C, Hahn, P, Danstrup, C, Petersen, NK, Ninn-Pedersen, M, Mikkelsen, S, Pauli, S, Fuglsang, S, Døssing, H, Christensen, A-L, Rusan, M & Kjeldsen, A 2021, 'Microbiology of parapharyngeal abscesses in adults: in search of the significant pathogens', European Journal of Clinical Microbiology & Infectious Diseases, bind 40, nr. 7, s. 1461-1470. https://doi.org/10.1007/s10096-021-04180-y

Microbiology of parapharyngeal abscesses in adults: in search of the significant pathogens. / Klug, Tejs Ehlers; Greve, Thomas; Andersen, Camilla et al.
I: European Journal of Clinical Microbiology & Infectious Diseases, Bind 40, Nr. 7, 07.2021, s. 1461-1470.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - Microbiology of parapharyngeal abscesses in adults: in search of the significant pathogens

AU - Klug, Tejs Ehlers

AU - Greve, Thomas

AU - Andersen, Camilla

AU - Hahn, Pernille

AU - Danstrup, Christian

AU - Petersen, Niels Krintel

AU - Ninn-Pedersen, Mirjana

AU - Mikkelsen, Sophie

AU - Pauli, Søren

AU - Fuglsang, Simon

AU - Døssing, Helle

AU - Christensen, Anne-Louise

AU - Rusan, Maria

AU - Kjeldsen, Anette

PY - 2021/7

Y1 - 2021/7

N2 - We aimed to describe the microbiology of parapharyngeal abscess (PPA) and point out the likely pathogens using the following principles to suggest pathogenic significance: (1) frequent recovery, (2) abundant growth, (3) growth in relative abundance to other microorganisms, (4) percentage of the isolates recovered in both absolute and relative abundance, (5) more frequent recovery in PPA pus compared with tonsillar surface and tissue. Comprehensive bacterial cultures were performed on specimens obtained from adult patients (n = 60) with surgically verified PPA, who were prospectively enrolled at five Danish ear-nose-throat departments. The prevalent isolates (in PPA pus) were unspecified anaerobes (73%), non-hemolytic streptococci (67%), Streptococcus anginosus group (SAG) (40%), Corynebacterium spp. (25%), Neisseria spp. (23%), Fusobacterium spp. (22%), Fusobacterium necrophorum (17%), Prevotella spp. (12%), and Streptococcus pyogenes (10%). The bacteria most frequently isolated in heavy (maximum) growth were unspecified anaerobes (60%), SAG (40%), F. necrophorum (23%), and Prevotella spp. (17%). The predominant microorganisms (those found in highest relative abundance) were unspecified anaerobes (53%), SAG (28%), non-hemolytic streptococci (25%), F. necrophorum (15%), S. pyogenes (10%), and Prevotella spp. (10%). Four potential pathogens were found in both heavy growth and highest relative abundance in at least 50% of cases: F. necrophorum, Prevotella spp., SAG, and S. pyogenes. SAG, Prevotella spp., F. necrophorum, S. pyogenes, and Bacteroides spp. were recovered with the same or higher frequency from PPA pus compared with tonsillar tissue and surface. Our findings suggest that SAG, F. necrophorum, Prevotella, and S. pyogenes are significant pathogens in PPA development.

AB - We aimed to describe the microbiology of parapharyngeal abscess (PPA) and point out the likely pathogens using the following principles to suggest pathogenic significance: (1) frequent recovery, (2) abundant growth, (3) growth in relative abundance to other microorganisms, (4) percentage of the isolates recovered in both absolute and relative abundance, (5) more frequent recovery in PPA pus compared with tonsillar surface and tissue. Comprehensive bacterial cultures were performed on specimens obtained from adult patients (n = 60) with surgically verified PPA, who were prospectively enrolled at five Danish ear-nose-throat departments. The prevalent isolates (in PPA pus) were unspecified anaerobes (73%), non-hemolytic streptococci (67%), Streptococcus anginosus group (SAG) (40%), Corynebacterium spp. (25%), Neisseria spp. (23%), Fusobacterium spp. (22%), Fusobacterium necrophorum (17%), Prevotella spp. (12%), and Streptococcus pyogenes (10%). The bacteria most frequently isolated in heavy (maximum) growth were unspecified anaerobes (60%), SAG (40%), F. necrophorum (23%), and Prevotella spp. (17%). The predominant microorganisms (those found in highest relative abundance) were unspecified anaerobes (53%), SAG (28%), non-hemolytic streptococci (25%), F. necrophorum (15%), S. pyogenes (10%), and Prevotella spp. (10%). Four potential pathogens were found in both heavy growth and highest relative abundance in at least 50% of cases: F. necrophorum, Prevotella spp., SAG, and S. pyogenes. SAG, Prevotella spp., F. necrophorum, S. pyogenes, and Bacteroides spp. were recovered with the same or higher frequency from PPA pus compared with tonsillar tissue and surface. Our findings suggest that SAG, F. necrophorum, Prevotella, and S. pyogenes are significant pathogens in PPA development.

KW - Fusobacterium

KW - Microbiology

KW - Parapharyngeal abscess

KW - Pathogens

KW - Streptococcus

KW - Bacteria/classification

KW - Humans

KW - Middle Aged

KW - Male

KW - Young Adult

KW - Adolescent

KW - Aged, 80 and over

KW - Adult

KW - Female

KW - Parapharyngeal Space/microbiology

KW - Aged

KW - Abscess/microbiology

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U2 - 10.1007/s10096-021-04180-y

DO - 10.1007/s10096-021-04180-y

M3 - Journal article

C2 - 33566204

SN - 0934-9723

VL - 40

SP - 1461

EP - 1470

JO - European Journal of Clinical Microbiology & Infectious Diseases

JF - European Journal of Clinical Microbiology & Infectious Diseases

IS - 7

ER -

Microbiology of parapharyngeal abscesses in adults: in search of the significant pathogens

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