380. Epidemiology and Clinical Outcomes in Patients with Fusobacterium Bacteremia in a Tertiary Hospital
Session: Poster Abstract Session: Epidemiology - Bacterial Infections
Friday, October 21, 2011
Room: Poster Hall B1
Handouts
  • ~~~Goldberg Fusobacterium Poster Draft 8~~~.pdf (179.2 kB)
  • Background: Fusobacterium (F) are anaerobic gram (-) bacilli, and are normal flora of the oral, gastrointestinal (GI), respiratory, vaginal, and colonic mucosa. Infection with F occurs as a result of disruption of mucosal surfaces, most often in elderly people, and patients (pts) with immunosuppression, diabetes (DM), renal insufficiency, or cardiovascular disease (CVD). Fusobacterium bacteremia (FB) accounts for 0.9% of all bacteremia cases, with a mortality rate of 40%. We described the epidemiology and outcomes of pts with FB at Summa Health System.

    Methods: A retrospective study was conducted in pts with FB from Jan 2001 to Dec 2010. Demographic, clinical, laboratory, treatment, and outcome data were collected. Statistical analysis was performed by using Fisher’s Exact Test to describe association with need of ICU and mortality, and t-test to asses factors associated with length of hospital stay (LHS).

    Results: Nineteen pts with FB were identified. The frequency of FB during this period was 0.01%. The mean age was 58.6 years and 16 pts were >40 years old. Sixteen patients were Caucasian, and 10 patients were female. The most common co-morbidities were CVD, steroid use, asthma/COPD, DM, and cancer. The most common symptoms were fever, mental change, hypotension, and hyperthermia. The most common lab abnormalities were leukocytosis, anemia, and increased creatinine. The infection sources were GI, GU, respiratory, and unclear in 21.0%. Thirteen pts required ICU, 7 pts were mechanically ventilated, and 18 pts were treated with antibiotics, with 78.9% of pts on appropriate antibiotic regiments. The 30 day mortality was 21.1%. Rise in creatinine and mental changes were associated with a significantly higher mortality with p-values of 0.0181 and 0.0374 respectively. CVD and DM were associated with a significant increase in LHS, with p-values of 0.0017 and 0.0010 respectively.

    Conclusion: FB is an uncommon event, with our incidence being over ten times lower than prior publications. The most common source of infection was GI. Increased creatinine and mental changes were associated with a significant increase in mortality. CVD and DM were associated with a significant increase in LHS.


    Subject Category: C. Clinical studies of bacterial infections and antibacterials including sexually transmitted diseases and mycobacterial infections (surveys, epidemiology, and clinical trials)

    Eric Goldberg, BS, NEOUCOM, Solon, OH, Mike Hewit, MS, NEOUCOM, rootstown, OH and Hector Bonilla, MD, Summa Health System, Akron, OH

    Disclosures:

    E. Goldberg, None

    M. Hewit, None

    H. Bonilla, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.