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Comparison of the effectiveness of bacterial culture, 16S rDNA directed polymerase chain reaction, and checkerboard DNA-dNA hybridization for detection of Fusobacterium nucleatum in endodontic infections.

Fusobacterium nucleatum is a Gram-negative, non-spore-forming, nonmotile, obligatory anaerobic rod that is normally isolated from the oral cavity. Epidemiological studies have shown that this species is one of the most prevalent in primary root canal infections. The purpose of this study was to compare the effectiveness of bacteriological culture, 16S rDNA directed polymerase chain reaction and checkerboard DNA-DNA hybridization for detection of F. nucleatum strains in infected teeth associated with periradicular lesions. Thirteen single-root teeth from adult patients, all having carious lesions, necrotic pulps, and radiographic evidence of periradicular bone loss were included in this study. Combining all methods, the results indicated that F. nucleatum was present in approximately 31% (4 of 13) of the specimens. Incidence of F. nucleatum in root canal infections, as evaluated in this study by polymerase chain reaction, culture, and DNA-DNA hybridization, was 15.4%, 15.4%, and 10.0%, respectively. Our data demonstrated that no method used herein could be considered superior for detecting F. nucleatum directly from clinical samples. However, the small number of samples examined and the low prevalence that was observed should be considered.

Adult↗

Fusobacterium necrophorum septicemia following oropharyngeal infection.

Fusobacterium necrophorum septicemia developed in five patients after an oropharyngeal infection. Four patients had sore throat or neck pain, and two had findings of jugular vein septic thrombophlebitis. Metastatic abscesses, including embolic pneumonia, empyema, septic arthritis, and osteomyelitis, also occurred. Four patients recovered and one died. Proper treatment requires recognition of the oropharyngeal source of the septicemia and its differentiation from endocarditis. Antibiotic therapy should be prolonged, and metastatic abscesses drained.

Adolescent↗

[Septic shock with liver abscess in an immunocompetence patient. Presentation of an unusual Fusobacterium nucleatum infection].

BACKGROUND: Fusobacterium septicemia with septic metastasis is a very rare and potentially serous condition when complicated by septic shock. Most cases have been described in patients with humoral immunity disorders and/or severe underlying chronic disease. CASE REPORT: A 24-year-old immunocompetent woman with a tonsil infection developed F. nucleatum septic shock with liver abscess formation. Outcome was rapidly favorable with antibiotic treatment and adapted intensive care, probably favored by the absence of an associated immune deficit. DISCUSSION: Despite its low incidence, F. nucleatum should be entertained as a possible cause of septicemia originating from a pelviperitoneal, pulmonary with abscess formation, or upper airway infection. Proper diagnosis is essential due to the risk of poor prognosis. Fusobacterium nucleatum is a commensal strictly anaerobic bacteria of the buccal cavity. It can cause dental and upper airway infections. Septicemia with secondary localization of F. nucleatum is very rare and the severity depends on the presence of associate septic shock. The immunopathological implications of these infections remain to be elucidated.

Adult↗

Clonality of Fusobacterium nucleatum in root canal infections.

Fusobacterium nucleatum is a gram-negative non-spore-forming, non-motile, obligate anaerobic rod that is normally isolated from the oral cavity. Several studies have reported a significant heterogeneity within the F. nucleatum species. The aim of the present study was to analyze the clonal diversity of F. nucleatum strains isolated from intracanal infections and to evaluate the presence of Enterobacterial Repetitive Intergenic Consensus (ERIC)-like sequences in the genome of F. nucleatum. Samples were collected from 13 single-root teeth from adult patients, all having carious lesions, necrotic pulps and radiographic evidence of periradicular bone loss. F. nucleatum was isolated from two different patients (subjects 5 and 7) by culture. Amplification of 19 colonies from subject 5 and 15 colonies from subject 7 using ERIC primers resulted in four clonal types, two per subject. An intense amplicon of approximately 700 bp was generated by ERIC-PCR for all F. nucleatum isolates and F. nucleatum ssp. polymorphum ATCC 10953. The amplification reaction using primer 1254 confirmed the results obtained with the ERIC primer. Our findings indicate that DNA fingerprints provided by ERIC- and Arbitrarily Primed (AP)-PCR may constitute a powerful tool for investigating F. nucleatum clonal diversity.

Adult↗

Cytology of pulmonary Fusobacterium nucleatum infection. A case report.

A patient with pulmonary Fusobacterium nucleatum infection presenting as a solitary nodule is reported. The infectious nature of the lung nodule was disclosed by ultrasound-guided percutaneous transthoracic fine needle aspiration cytology (FNAC) with Liu's stain. The cytologic characteristics of F nucleatum infection are described. The usefulness of real-time ultrasound in fine needle aspiration diagnosis of a peripheral lung lesion is demonstrated, and the role of Liu's stain in FNAC is emphasized.

Biopsy, Needle↗

[Multiple liver abscesses caused by Fusobacterium necrophorum infection].

A case of multiple liver abscesses caused by Fusobacterium necrophorum infection is presented. In cases with fever of unknown origin and biochemical signs of derangement of hepatic function, it is recommended that an abdominal scan is performed. Before initiating antibiotic treatment relevant specimens should be collected. Finally we describe how the use of resin-containing blood culture medium enhance the possibility of bacterial detection in patients receiving antibiotics.

Diagnosis, Differential↗

Delayed-type hypersensitivity in mice experimentally infected with Fusobacterium necrophorum.

The foot-pad test was performed to reveal the induction of delayed-type hypersensitivity (DTH) to Fusobacterium necrophorum in mice experimentally infected with F. necrophorum. For the foot-pad test, heat-killed cells of F. necrophorum were found to be better than viable bacteria as eliciting antigens. The thickness of foot-pad could be measured properly at 48 hr after administration to the foot-pad of heat-killed bacteria. An intraperitoneal dose of the order of 10(5) or 10(6) of viable bacteria evoked a similar foot-pad response. Peak responses were found on days 4 and 14 after the sensitization. The response was found to be specific. This response could be transferred by spleen cells to genetically homogeneous mice, but not to genetically heterogeneous mice. Serum could not transfer the response to either heterogeneous or homogeneous mice. Thus, these results indicate that DTH could be induced by F. necrophorum.

Animals↗

Fusobacterium necrophorum infections: virulence factors, pathogenic mechanism and control measures.

Fusobacterium necrophorum, a Gram-negative, non-spore-forming anaerobe, is a normal inhabitant of the alimentary tract of animals and humans. Two types of F. necrophorum, subspecies necrophorum (biotype A) and funduliforme (biotype B), have been recognized, which differ morphologically, biochemically, and biologically. The organism is an opportunistic pathogen that causes numerous necrotic conditions (necrobacillosis) such as bovine hepatic abscesses, ruminant foot abscesses and human oral infections. The pathogenic mechanism of F. necrophorum is complex and not well defined. Several toxins, such as leukotoxin, endotoxin, haemolysin, haemagglutinin and adhesin, have been implicated as virulence factors. Among these, leukotoxin and endotoxin are believed to be more important than other toxins in overcoming the host's defence mechanisms to establish the infection. F. necrophorum is encountered frequently in mixed infections and, therefore, synergisms between F. necrophorum and other pathogens may play an important role in infection. Several investigators have attempted to induce protective immunity against F. necrophorum using bacterins, toxoids, and other cytoplasmic components. Generally, none of the immunogens has afforded satisfactory protection against Fusobacterium infections. Because of the unavailability of suitable immunoprophylaxis, the control of F. necrophorum infection has depended mainly on the use of antimicrobial compounds.

Animals↗

Immunization of mice against Fusobacterium necrophorum infection by perenteral or oral administration of vaccine.

Immunization of mice against Fusobacterium necrophorum infection was attempted by using 3 vaccination procedures: (1) intraperitoneal (IP) injection of F necrophorum cells in saline solution, (2) IP injection of cells with added aluminum hydroxide adjuvant, and (3) feeding of a powdered mouse diet containing lyophilized cells. One or 2 weekly IP injections of the bacteria cells (in saline solution) for 3, 6, or 12 weeks resulted in protection of 48.7% to 64.5% of the mice against challenge exposure. Of the 2 control groups (given saline solution only), 100% and 97.4% became infected. Weekly IP injections of bacterial cells in an aluminum hydroxide adjuvant for 3, 6, or 12 weeks resulted in protectivity of 54.1% to 77.5%. Of the control mice (given adjuvant only), 97.5% became infected. Bacterial cells fed to mice at a dose level of 1.5 mg (dry weight)/g of powdered diet for 30 days (4 or 5g of diet each day) resulted in only a delay in the mean time of death as compared with the rapid death of the control mice. The feeding dose of 0.15 mg of cells/g of diet did not delay the mean time of death.

Adjuvants, Immunologic↗

The adverse effect of dilution on the infectivity of Fusobacterium necrophorum culture.

Dilution had an adverse effect on the infectivity of 24 h cultures of a strain of Fusobacterium necrophorum, which became apparent at or near the minimum lethal dose. Thus in mice inoculated subcutaneously the mortality produced by 0.01 ml of undiluted culture was almost invariably greater than that produced by 0.1 ml of a 1 in 10 dilution. The explanation appeared to lie in the increased physical separation of bacterial cells that was the inevitable consequence of dilution.

Animals↗

[Pulmonary infection caused by Fusobacterium nucleatum].

Thoracic infection by anaerobes are uncommon diseases and often presents difficulty in diagnosis. We report a case of thoracic infection due to Fusobacterium Nucleatum. A 60-year old man presented a lesion infiltrating from the lung to the thoracic wall. Fusobacterium Nucleatum was isolated on pus collected. Treatment by penicillin, metronidazole combined with surgical drainage was highly effective.

Anti-Bacterial Agents↗

Failure to induce in rabbits effective immunity to a mixed infection of Fusobacterium necrophorum and Corynebacterium pyogenes with a combined bacterin.

Failure to induce in rabbits effective immunity to a mixed infection of Fusobacterium necrophorum and Corynebacterium pyogenes with a combined bacterin. Onderstepoort Journal of Veterinary Research, 44 (4), 253--2;6 (1977). Rabbits were immunized with alum-precipitated, oil adjuvant and an untreated bacterin composed of F. necrophorum and C. pyogenes. Immunized rabbits were challenged intradermally with a mixture of F. necrophorum and C. pyrogenes. Immunized rabbits were challenged intradermally with a mixture of F. necorphorum and C. pyrogenes. Initially a low level of initial transient resistance could be demonstrated but a solid immunity could not be established.

Animals↗

[Retrospective analysis of Fusobacterium associated infections; experience at Aomori Prefectural Hospital with 108 cases from 1995 to 1999].

We experienced 108 cases of Fusobacterium associated infections, including otolaryngeal, oral, pleuropulmonary, intraabdominal, skin and soft tissue infections, at Aomori Prefectural Hospital during The 5 year-period from 1995 to 1999. A total of 433 organisms, included 113 Fusobacterium spp. (80 Fusobacterium nucleatum, 18 Fusobaterium necrophorum, 5 Fusobacterium varium, 4 Fusobacterium mortiferum, 6 Fusobacterium spp.), were recovered with an average of 4.0 organisms per case of the 108 cases, 68% were mixed aerobic and anaerobic and yielded 185 anaerobic bacteria (2.5 per case) and 137 aerobic bacteria (1.9 per case) with an average of 4.4 per case. The remaining 32% were purely anaerobic and yielded 111 organisms with an average of 3.2 per case, Prevotella spp., Bacteroides fragilis group, Streptococcus milleri group, Enterobacteriaceae, Peptostreptococcus spp. Staphylococcus spp. were most frequently coisolated with Fusobacterium spp.

Adult↗

Further observations on enhancement of the infectivity of Fusobacterium necrophorum by other bacteria.

It had already been shown with a single virulent strain (A42) of Fusobacterium necrophorum that suspension of the fusobacteria in sub-lethal doses of broth cultures of other bacteria reduced the minimum infective dose (greater than 10(6) organisms) for mice by subcutaneous inoculation, sometimes to less than 10 organisms. The present study extended the known range of bacteria with strong infectivity-enhancing properties to include Bacillus cereus, Klebsiella oxytoca and Staphylococcus aureus; and those with weaker effect to include Bacillus subtilis, 'Bacteroides melaninogenicus', Clostridium sporogenes, Pasteurella haemolytica, and Proteus mirabilis. The study also showed that five further virulent strains of F. necrophorum closely resembled A42 in respect of striking susceptibility to infectivity enhancement by Escherichia coli. Actinomyces (Corynebacterium) pyogenes and S. aureus. One further strain (A6) of F. necrophorum resembled A42 in respect of strong infectivity enhancement by A. pyogenes, S. aureus, B. cereus and K. oxytoca but differed from it and the other five strains in being only slightly affected by E. coli. This work was a necessary prelude to the development of a method, based on infectivity enhancement, for the detection and isolation of F. necrophorum present in small numbers in heavily contaminated material such as faeces.

Actinomycosis↗

Evaluation of experimentally induced Fusobacterium necrophorum infections in mice.

Two strains of mice, Swiss Webster and DBA/2Cr, were injected intraperitoneally or intravenously with varying dosages of Fusobacterium necrophorum. The ability to eliminate the infection was assessed by quantitative enumeration of the organisms present in the blood, liver, and spleen, Three- to 4-week-old DBA/2Cr mice were highly resistant to both routes of injection. The intraperitoneal injection of older mice failed to demonstrate a dose-effect relationship whereas an intravenous injection of as few as 10(4) cells of F. necrophorum produced progressively necrotic leg abscesses, apparently involving the lymphonodus ischiadicus which filters the site of injection. Mortality was increased with sensitization by a previous sublethal injection. Also, an ethanol-killed cell vaccine delayed the onset of lethal infection, whereas repeated sublethal live cell injections provided nonspecific protection since mice vaccinated with the growth medium were equally protected. The development of leg abscesses after intravenous injection visibly demonstrated the pathogenicity of F. necrophorum and may provide a suitable model for the evaluation of vaccines and the effectiveness of antibiotics.

Age Factors↗

Enhancement of the infectivity of Fusobacterium necrophorum by other bacteria.

Necrobacillosis is caused by Fusobacterium necrophorum (FN), but other organisms are often present in the lesions. Their possible role was studied in experiments made with a virulent FN strain which, by itself, produced fatal necrobacillosis in mice provided that large doses (greater than 10(6) organisms, subcutaneously) were given. Mice were inoculated subcutaneously with FN suspended in sub-lethal doses (0.1 ml) of undiluted or diluted broth cultures of other bacteria. Undiluted culture of a strain of Escherichia coli reduced the infective dose of FN to less than 10 organisms; in the necrobacillosis lesions that developed, fusobacteria greatly outnumbered E. coli. A heat-killed preparation or sterile filtrate of E. coli culture had little if any effect on FN. Citrobacter freundii and comparatively small numbers of Corynebacterium (Actinomyces) pyogenes produced effects similar to that of E. coli. An alpha-haemolytic streptococcus, Pseudomonas aeruginosa, Bacteroides fragilis and Fusobacterium nucleatum also enhanced the infectivity of FN, though less strikingly than E. coli. FN increased the persistence in vivo of the alpha-haemolytic streptococcus and B. fragilis, and enabled the latter to multiply profusely.

Animals↗