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- Nygren, David, et al.
(author)
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Geographical differences in tonsillar carriage rates of Fusobacterium necrophorum – A cross-sectional study in Sweden and Zambia
- 2021
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In: Anaerobe. - : Elsevier BV. - 1075-9964. ; 69
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Journal article (peer-reviewed)abstract
- While Fusobacterium necrophorum historically has been considered normal tonsillar flora, recent studies from Europe and the US have suggested that carriage occur transiently in adolescence and young adulthood. However, no studies originating from Africa exist. In this cross-sectional study of tonsillar carriage of F. necrophorum, we aimed to investigate geographical differences in tonsillar carriage rates of F. necrophorum in healthy participants aged 15–25 years in Sweden and Zambia and further investigate the age distribution of tonsillar carriage in Zambia. Specimens were obtained by tonsillar swabs and analyzed with real-time PCR for F. necrophorum. In participants aged 15–25 years, tonsillar carriage was more common in Sweden 21/100 (21%) than in Zambia 6/192 (3%), p < 0.001. In Zambian participants aged above 25 years tonsillar carriage was rare 1/76 (1%). In conclusion, the high rate of tonsillar carriage in participants aged 15–25 years in Sweden has implications on the interpretation of tonsillar findings in patients with pharyngotonsillitis. Interestingly, a geographical difference was found with tonsillar carriage rarely identified in Zambia.
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| 2. |
- Nygren, David, et al.
(author)
-
Geographical differences in tonsillar carriage rates of Fusobacterium necrophorum – A cross-sectional study in Sweden and Zambia
- 2022
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In: ; , s. 139-139
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Conference paper (other academic/artistic)abstract
- Background: Previously, we investigated tonsillar carriage of Fusobacterium necrophorum by PCR and found a high tonsillar carriage rate (21%) in asymptomatic 15-25year olds, but the same age group is most commonly affected by severe F. necrophorum infections. Interestingly, we found Cycle threshold (Ct)-values in asymptomaticcarriers to be high (median 29). Possibly, the Ct-value could differentiate betweeninfection and tonsillar carriage, with bacterial load hypothetically being higher oninfected tonsils. The purpose of this study was to investigate differences in F. necrophorum Ct-values in patients diagnosed with pharyngotonsillitis who did or did notdevelop complications.Methods: Patients with pharyngotonsillitis and positive F. necrophorum-PCR were enrolled from July 2016 - December 2020 in the Skåne Region, Sweden. Patients with prior complications or antibiotics (30 days) were excluded. Data was retrieved from registries and electronic charts. Patients were grouped by presence of any complication within 30 days, defined as a composite score of peritonsillar or pharyngeal abscess, otitis, sinusitis, sepsis or septic complications, chronic or recurrent tonsillitis (after 15-30 days) or hospitalization. Ct-values were presented with median and interquartile range (IQR) and compared with the Mann-Whitney U-test. Results: In total, 969 patients had pharyngotonsillitis and positive F. necrophorum-PCR. 29% developed complications. There was no difference in Ct-values between patients who did (median 21, IQR 19-25) or did not (median 21, IQR19-26) develop complications (p=0.51). Conclusion: In pharyngotonsillitis patients warranting extended work up for F. necrophorum, no difference in Ct-values between patients who did or did not develop complications was found. Most patients with pharyngotonsillitis had lower Ct-values than previously described in asymptomatic individuals, however factors such as degree of inflammation of tonsils, sampling technique and symptom duration were not accounted for.
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