Fusobacterium necrophorum: most prevalent pathogen in peritonsillar abscess in Denmark

Tejs Ehlers Klug; Maria Rusan; Kurt Fuursted; Therese Ovesen

doi:10.1086/644616

Fusobacterium necrophorum: most prevalent pathogen in peritonsillar abscess in Denmark

Tejs Ehlers Klug, Maria Rusan, Kurt Fuursted, Therese Ovesen

Department of Clinical Medicine - The Department of Oto-Rhino-Laryngology

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

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Abstract

BACKGROUND: Group A streptococci are commonly regarded as the most prevalent cause of acute bacterial tonsillitis and peritonsillar abscess (PTA). However, the majority of PTA aspirates also contain strains of anaerobes, and accumulating evidence indicates that Fusobacterium necrophorum (FN) could be involved in acute tonsillitis. The purpose of the present study was to describe the epidemiology and bacteriology of PTA in Denmark, with particular emphasis on correlations between microbiological, clinical, and laboratory data. METHODS: A retrospective study on all patients with PTA admitted to the ear, nose, and throat department at Aarhus University Hospitals from January 2001 through December 2006 was conducted. RESULTS: In total, 847 patients were included in the study. The mean annual incidence of PTA was 41 cases/100,000 population. FN was the most frequently detected bacteria (in 23% of cultures), followed by group A streptococci (in 17%) and groups C and G streptococci (counted together, in 5%). Of the 191 FN isolates detected, 155 (81%) grew as pure culture. Patients infected with FN were significantly younger than patients infected with other strains of bacteria ([Formula: see text]). Patients with FN exhibited significantly higher neutrophil counts ([Formula: see text]) and C-reactive protein values ([Formula: see text]) than did patients infected with other bacteria. CONCLUSIONS: To our knowledge, this study is the first report of FN being the most prevalent pathogen in PTA patients. The significantly higher neutrophil counts and C-reactive protein values strongly indicate the pathogenic importance of FN in PTA. The widespread reliance on rapid streptococcal antigen test in general practice to appoint patients for antibiotics and the highest PTA incidence ever reported raise concern that highly virulent bacteria may be left initially untreated.

Original language	English
Journal	Clinical Infectious Diseases
Volume	49
Issue	10
Pages (from-to)	1467-72
Number of pages	5
ISSN	1058-4838
DOIs	https://doi.org/10.1086/644616
Publication status	Published - 2009

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@article{9f659040010211df9c17000ea68e967b,

title = "Fusobacterium necrophorum: most prevalent pathogen in peritonsillar abscess in Denmark",

abstract = "BACKGROUND: Group A streptococci are commonly regarded as the most prevalent cause of acute bacterial tonsillitis and peritonsillar abscess (PTA). However, the majority of PTA aspirates also contain strains of anaerobes, and accumulating evidence indicates that Fusobacterium necrophorum (FN) could be involved in acute tonsillitis. The purpose of the present study was to describe the epidemiology and bacteriology of PTA in Denmark, with particular emphasis on correlations between microbiological, clinical, and laboratory data. METHODS: A retrospective study on all patients with PTA admitted to the ear, nose, and throat department at Aarhus University Hospitals from January 2001 through December 2006 was conducted. RESULTS: In total, 847 patients were included in the study. The mean annual incidence of PTA was 41 cases/100,000 population. FN was the most frequently detected bacteria (in 23% of cultures), followed by group A streptococci (in 17%) and groups C and G streptococci (counted together, in 5%). Of the 191 FN isolates detected, 155 (81%) grew as pure culture. Patients infected with FN were significantly younger than patients infected with other strains of bacteria ([Formula: see text]). Patients with FN exhibited significantly higher neutrophil counts ([Formula: see text]) and C-reactive protein values ([Formula: see text]) than did patients infected with other bacteria. CONCLUSIONS: To our knowledge, this study is the first report of FN being the most prevalent pathogen in PTA patients. The significantly higher neutrophil counts and C-reactive protein values strongly indicate the pathogenic importance of FN in PTA. The widespread reliance on rapid streptococcal antigen test in general practice to appoint patients for antibiotics and the highest PTA incidence ever reported raise concern that highly virulent bacteria may be left initially untreated.",

author = "{Ehlers Klug}, Tejs and Maria Rusan and Kurt Fuursted and Therese Ovesen",

year = "2009",

doi = "10.1086/644616",

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pages = "1467--72",

journal = "Clinical Infectious Diseases",

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T1 - Fusobacterium necrophorum: most prevalent pathogen in peritonsillar abscess in Denmark

AU - Ehlers Klug, Tejs

AU - Rusan, Maria

AU - Fuursted, Kurt

AU - Ovesen, Therese

PY - 2009

Y1 - 2009

N2 - BACKGROUND: Group A streptococci are commonly regarded as the most prevalent cause of acute bacterial tonsillitis and peritonsillar abscess (PTA). However, the majority of PTA aspirates also contain strains of anaerobes, and accumulating evidence indicates that Fusobacterium necrophorum (FN) could be involved in acute tonsillitis. The purpose of the present study was to describe the epidemiology and bacteriology of PTA in Denmark, with particular emphasis on correlations between microbiological, clinical, and laboratory data. METHODS: A retrospective study on all patients with PTA admitted to the ear, nose, and throat department at Aarhus University Hospitals from January 2001 through December 2006 was conducted. RESULTS: In total, 847 patients were included in the study. The mean annual incidence of PTA was 41 cases/100,000 population. FN was the most frequently detected bacteria (in 23% of cultures), followed by group A streptococci (in 17%) and groups C and G streptococci (counted together, in 5%). Of the 191 FN isolates detected, 155 (81%) grew as pure culture. Patients infected with FN were significantly younger than patients infected with other strains of bacteria ([Formula: see text]). Patients with FN exhibited significantly higher neutrophil counts ([Formula: see text]) and C-reactive protein values ([Formula: see text]) than did patients infected with other bacteria. CONCLUSIONS: To our knowledge, this study is the first report of FN being the most prevalent pathogen in PTA patients. The significantly higher neutrophil counts and C-reactive protein values strongly indicate the pathogenic importance of FN in PTA. The widespread reliance on rapid streptococcal antigen test in general practice to appoint patients for antibiotics and the highest PTA incidence ever reported raise concern that highly virulent bacteria may be left initially untreated.

AB - BACKGROUND: Group A streptococci are commonly regarded as the most prevalent cause of acute bacterial tonsillitis and peritonsillar abscess (PTA). However, the majority of PTA aspirates also contain strains of anaerobes, and accumulating evidence indicates that Fusobacterium necrophorum (FN) could be involved in acute tonsillitis. The purpose of the present study was to describe the epidemiology and bacteriology of PTA in Denmark, with particular emphasis on correlations between microbiological, clinical, and laboratory data. METHODS: A retrospective study on all patients with PTA admitted to the ear, nose, and throat department at Aarhus University Hospitals from January 2001 through December 2006 was conducted. RESULTS: In total, 847 patients were included in the study. The mean annual incidence of PTA was 41 cases/100,000 population. FN was the most frequently detected bacteria (in 23% of cultures), followed by group A streptococci (in 17%) and groups C and G streptococci (counted together, in 5%). Of the 191 FN isolates detected, 155 (81%) grew as pure culture. Patients infected with FN were significantly younger than patients infected with other strains of bacteria ([Formula: see text]). Patients with FN exhibited significantly higher neutrophil counts ([Formula: see text]) and C-reactive protein values ([Formula: see text]) than did patients infected with other bacteria. CONCLUSIONS: To our knowledge, this study is the first report of FN being the most prevalent pathogen in PTA patients. The significantly higher neutrophil counts and C-reactive protein values strongly indicate the pathogenic importance of FN in PTA. The widespread reliance on rapid streptococcal antigen test in general practice to appoint patients for antibiotics and the highest PTA incidence ever reported raise concern that highly virulent bacteria may be left initially untreated.

U2 - 10.1086/644616

DO - 10.1086/644616

M3 - Journal article

C2 - 19842975

SN - 1058-4838

VL - 49

SP - 1467

EP - 1472

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 10

ER -

Fusobacterium necrophorum: most prevalent pathogen in peritonsillar abscess in Denmark

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