Skip to main content
Top
Published in: BMC Infectious Diseases 1/2015

Open Access 01-12-2015 | Research article

Tonsillar colonisation of Fusobacterium necrophorum in patients subjected to tonsillectomy

Authors: Helena Björk, Lena Bieber, Katarina Hedin, Martin Sundqvist

Published in: BMC Infectious Diseases | Issue 1/2015

Login to get access

Abstract

Background

Fusobacterium necrophorum is a well-known cause of Lemirre’s disease and accumulating evidence support its pathogenic role in peritonsillar abscess while its role in recurrent and chronic tonsillitis is uncertain. The objective of this study was to assess the prevalence of oropharyngeal colonisation with F. necrophorum and Beta-haemolytic streptococci in a cohort of patients scheduled for tonsillectomy due to recurrent or persistent throat pain, and to evaluate the dynamics of colonisation with repeated sampling during a follow-up time of 6 to 8 months.

Methods

Fifty-seven (57) patients aged 15–52 years scheduled for tonsillectomy due to chronic/recurrent tonsillitis or recurrent peritonsillar abscess were included. Throat swabs for the detection of F. necrophorum and Beta-haemolytic streptococci and clinical data was collected at inclusion, at the time of surgery and 6 to 8 months after surgery. Statistical analysis was performed using the Chi-square, Fisher’s exact and Mc Nemar tests.

Results

Fusobacterium necrophorum was found in 28, 30 and 16 % of the patients at inclusion, surgery and follow up respectively. The corresponding results for beta-haemolytic streptococci were 5, 9 and 5 %. Patients colonised with F. necrophorum at follow-up, after tonsillectomy, were equally relieved from their previous throat pain as non-colonised patients. Looking at individual patients, the culture results for F. necrophorum varied over time, indicating a transient colonisation.

Conclusion

Fusobacterium necrophorum was frequently found in throat cultures in this cohort of patients with recurrent or chronic throat pain leading to tonsillectomy. Colonisation was equally frequent in the asymptomatic cohort post-tonsillectomy, indicating that F. necrophorum is not alone causative of the symptoms. In an individual perspective, colonisation with F. necrophorum was transient over time.
Literature
1.
go back to reference Paradise JL, Bluestone CD, Bachman RZ, Colborn DK, Bernard BS, Taylor FH, et al. Efficacy of tonsillectomy for recurrent throat infection in severely affected children. N Engl J Med. 1984;310(11):674–83.CrossRefPubMed Paradise JL, Bluestone CD, Bachman RZ, Colborn DK, Bernard BS, Taylor FH, et al. Efficacy of tonsillectomy for recurrent throat infection in severely affected children. N Engl J Med. 1984;310(11):674–83.CrossRefPubMed
2.
go back to reference Medical Products Agency. Management of pharyngotonsillitis – recommendations. (Handläggning av faryngotonsilliter - rekommendationer). Info från Läkemedelsverket. 2001;12(7):44–9. Medical Products Agency. Management of pharyngotonsillitis – recommendations. (Handläggning av faryngotonsilliter - rekommendationer). Info från Läkemedelsverket. 2001;12(7):44–9.
3.
go back to reference Koskenkorva T, Koivunen P, Koskela M, Niemela O, Kristo A, Alho OP. Short-term outcomes of tonsillectomy in adult patients with recurrent pharyngitis: a randomized controlled trial. CMAJ. 2013;185(8):E331–6.CrossRefPubMedPubMedCentral Koskenkorva T, Koivunen P, Koskela M, Niemela O, Kristo A, Alho OP. Short-term outcomes of tonsillectomy in adult patients with recurrent pharyngitis: a randomized controlled trial. CMAJ. 2013;185(8):E331–6.CrossRefPubMedPubMedCentral
4.
go back to reference Klug TE, Rusan M, Fuursted K, Ovesen T. Fusobacterium necrophorum: Most Prevalent Pathogen in Peritonsillar Abscess in Denmark. Clin Infect Dis. 2009;49:1467–72.CrossRef Klug TE, Rusan M, Fuursted K, Ovesen T. Fusobacterium necrophorum: Most Prevalent Pathogen in Peritonsillar Abscess in Denmark. Clin Infect Dis. 2009;49:1467–72.CrossRef
7.
go back to reference Alho OP, Koivunen P, Penna T, Teppo H, Koskela M, Luotonen J. Tonsillectomy versus watchful waiting in recurrent streptococcal pharyngitis in adults: randomised controlled trial. BMJ. 2007;334(7600):939.CrossRefPubMedPubMedCentral Alho OP, Koivunen P, Penna T, Teppo H, Koskela M, Luotonen J. Tonsillectomy versus watchful waiting in recurrent streptococcal pharyngitis in adults: randomised controlled trial. BMJ. 2007;334(7600):939.CrossRefPubMedPubMedCentral
8.
go back to reference Stjernquist-Desatnik A, Prellner K, Schalén C. High recovery of Haemophilus influenzae and group A streptococci in recurrent tonsillar infection or hypertrophy as compared with normal tonsils. J Laryngol Otol. 1991;105(6):439–41.CrossRefPubMed Stjernquist-Desatnik A, Prellner K, Schalén C. High recovery of Haemophilus influenzae and group A streptococci in recurrent tonsillar infection or hypertrophy as compared with normal tonsils. J Laryngol Otol. 1991;105(6):439–41.CrossRefPubMed
9.
go back to reference Zautner AE, Krause M, Stropahl G, Holtfreter S, Frickmann H, Maletzki C, et al. Intracellular persisting Staphylococcus aureus is the major pathogen in recurrent tonsillitis. PLoS One. 2010;5(3), e9452.CrossRefPubMedPubMedCentral Zautner AE, Krause M, Stropahl G, Holtfreter S, Frickmann H, Maletzki C, et al. Intracellular persisting Staphylococcus aureus is the major pathogen in recurrent tonsillitis. PLoS One. 2010;5(3), e9452.CrossRefPubMedPubMedCentral
10.
go back to reference Woo JH, Kim ST, Kang IG, Lee JH, Cha HE, Kim D. Comparison of tonsillar biofilms between patients with recurrent tonsillitis and a control group. Acta Otolaryngol. 2012;132(10):1115–20.CrossRefPubMed Woo JH, Kim ST, Kang IG, Lee JH, Cha HE, Kim D. Comparison of tonsillar biofilms between patients with recurrent tonsillitis and a control group. Acta Otolaryngol. 2012;132(10):1115–20.CrossRefPubMed
11.
go back to reference Sanders CC, Sanders WE, Harrowe DJ. Bacterial interference: effects of oral antibiotics on the normal throat flora and its ability to interfere with Group A Streptococci. Infect Immun. 1976;13(3):808–12.PubMedPubMedCentral Sanders CC, Sanders WE, Harrowe DJ. Bacterial interference: effects of oral antibiotics on the normal throat flora and its ability to interfere with Group A Streptococci. Infect Immun. 1976;13(3):808–12.PubMedPubMedCentral
12.
go back to reference Aliyu SH, Marriott RK, Curran MD, Parmar S, Bentley N, Brown NM, et al. Real-time PCR investigation into the importance of Fusobacterium necrophorum as a cause of acute phayngitis in general practice. J Med Microbiol. 2004;53(10):1029–35.CrossRefPubMed Aliyu SH, Marriott RK, Curran MD, Parmar S, Bentley N, Brown NM, et al. Real-time PCR investigation into the importance of Fusobacterium necrophorum as a cause of acute phayngitis in general practice. J Med Microbiol. 2004;53(10):1029–35.CrossRefPubMed
13.
go back to reference Batty A, Wren MWD. Prevalence of Fusobacterium necrophorum and other upper respiratory tract pathogens isolated from throat swabs. Br J Biomed Sci. 2005;62(2):66–70.CrossRefPubMed Batty A, Wren MWD. Prevalence of Fusobacterium necrophorum and other upper respiratory tract pathogens isolated from throat swabs. Br J Biomed Sci. 2005;62(2):66–70.CrossRefPubMed
14.
go back to reference Jensen A, Hagelskjaer Kristensen L, Prag J. Detection of Fusobacterium necrophorum subsp. funduliforme in tonsillitis in young adults by real-time PCR. Clin Microbiol Infect. 2007;13(7):695–701.CrossRefPubMed Jensen A, Hagelskjaer Kristensen L, Prag J. Detection of Fusobacterium necrophorum subsp. funduliforme in tonsillitis in young adults by real-time PCR. Clin Microbiol Infect. 2007;13(7):695–701.CrossRefPubMed
15.
go back to reference Centor RM. Expand the pharyngitis paradigm for adolescents and young adults. Ann Intern Med. 2009;151(11):812–5.CrossRefPubMed Centor RM. Expand the pharyngitis paradigm for adolescents and young adults. Ann Intern Med. 2009;151(11):812–5.CrossRefPubMed
16.
go back to reference Jousimies-Somer H, Savolainen S, Mäkitie A, Ylikoski J. Bacteriologic findings in Peritonsillar abscesses in young adults. Clin Infect Dis. 1993;16 Suppl 4:S292–8.CrossRefPubMed Jousimies-Somer H, Savolainen S, Mäkitie A, Ylikoski J. Bacteriologic findings in Peritonsillar abscesses in young adults. Clin Infect Dis. 1993;16 Suppl 4:S292–8.CrossRefPubMed
17.
go back to reference Riordan T. Human infection with Fusobacterium necrophorum (Necrobacillosis), with a focus on Lemièrre’s syndrome. Clin Microbiol Rev. 2007;20(4):622–59.CrossRefPubMedPubMedCentral Riordan T. Human infection with Fusobacterium necrophorum (Necrobacillosis), with a focus on Lemièrre’s syndrome. Clin Microbiol Rev. 2007;20(4):622–59.CrossRefPubMedPubMedCentral
18.
19.
go back to reference Jensen A, Fagö-Olsen H, Sørensen CH, Kilian M. Molecular mapping to species level of the tonsillar crypt microbiota associated with health and recurrent tonsillitis. PLoS One. 2013;8(2), e56418.CrossRefPubMedPubMedCentral Jensen A, Fagö-Olsen H, Sørensen CH, Kilian M. Molecular mapping to species level of the tonsillar crypt microbiota associated with health and recurrent tonsillitis. PLoS One. 2013;8(2), e56418.CrossRefPubMedPubMedCentral
20.
go back to reference Ludlam H, Howard J, Kingston B, Donachie L, Foulkes J, Guha S, et al. Epidemiology of pharyngeal carriage of Fusobacterium necrophorum. J Med Microbiol. 2009;58(Pt 9):1264–5.CrossRefPubMed Ludlam H, Howard J, Kingston B, Donachie L, Foulkes J, Guha S, et al. Epidemiology of pharyngeal carriage of Fusobacterium necrophorum. J Med Microbiol. 2009;58(Pt 9):1264–5.CrossRefPubMed
21.
go back to reference Hedin K, Bieber L, Lindh M, Sundqvist M. The aetiology of pharyngotonsillitis in young adults. Clin Microb Infect. 2015;21(3):263.el-7.CrossRef Hedin K, Bieber L, Lindh M, Sundqvist M. The aetiology of pharyngotonsillitis in young adults. Clin Microb Infect. 2015;21(3):263.el-7.CrossRef
22.
go back to reference Klug TE, Henriksen JJ, Fuursted K, Ovesen T. Significant pathogens in peritonsillar abscess. Eur J Clin Microbiol Infect Dis. 2011;30(5):619–27.CrossRefPubMed Klug TE, Henriksen JJ, Fuursted K, Ovesen T. Significant pathogens in peritonsillar abscess. Eur J Clin Microbiol Infect Dis. 2011;30(5):619–27.CrossRefPubMed
23.
go back to reference Klug TE, Henriksen JJ, Rusan M, Fuursted K, Krogfelt KA, Ovesen T, et al. Antibody development to Fusobacterium necrophorum in patients with peritonsillar abscess. Eur J Clin Microbiol Infect Dis. 2014;33(10):1733–9.CrossRefPubMed Klug TE, Henriksen JJ, Rusan M, Fuursted K, Krogfelt KA, Ovesen T, et al. Antibody development to Fusobacterium necrophorum in patients with peritonsillar abscess. Eur J Clin Microbiol Infect Dis. 2014;33(10):1733–9.CrossRefPubMed
24.
go back to reference Stenfors LE, Bye HM, Räisänen S, Myklebust R. Bacterial penetration into tonsillar surface epithelium during infectious mononucleosis. J Laryngol Otol. 2000;114(11):848–52.PubMed Stenfors LE, Bye HM, Räisänen S, Myklebust R. Bacterial penetration into tonsillar surface epithelium during infectious mononucleosis. J Laryngol Otol. 2000;114(11):848–52.PubMed
25.
26.
go back to reference Hagelskjaer Kristensen L, Prag J. Human Necrobacillosis with Emphasis on Lemièrre’s Syndrome. Clin Infect Dis. 2000;31(2):524–32.CrossRefPubMed Hagelskjaer Kristensen L, Prag J. Human Necrobacillosis with Emphasis on Lemièrre’s Syndrome. Clin Infect Dis. 2000;31(2):524–32.CrossRefPubMed
Metadata
Title
Tonsillar colonisation of Fusobacterium necrophorum in patients subjected to tonsillectomy
Authors
Helena Björk
Lena Bieber
Katarina Hedin
Martin Sundqvist
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2015
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-015-0975-z

Other articles of this Issue 1/2015

BMC Infectious Diseases 1/2015 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine