Background
Capnocytophaga is a Gram-negative, facultative anaerobe. Human infection is rare but can lead to devastating outcomes. C. canimorsus can cause sepsis following an animal bite, whereas human-oral associated Capnocytophaga infections were reported in immunocompromised patients. Current data on these infections is not robust. Our goal is to provide a contemporary description of a unique characteristic of Capnocytophaga infections.
Methods
We performed a retrospective review of all patients with Capnocytophaga infection from January 2010 to August 2020 at three main hospitals of Mayo Clinic in Rochester, Minnesota, Scottsdale, Arizona, and Florida. We collected baseline demographic data, clinical characteristics, microbiological data, and outcomes of C. canimorsus and human-oral associated Capnocytophaga infection.
Results
Among 82 patients with Capnocytophaga infection, 46 patients (56.0%) had bacteremia. The most common species identified in this group was C. sputigena (57.9%), followed by C. canimorsus (34.8%). Patients with human-oral associated Capnocytophaga bacteremia were often immunocompromised, presented with neutropenic fever, and had worse six months all-cause mortality compared to C. canimorsus bacteremia (36.4% vs. 6.2%, p=.03). They also had a higher beta-lactamase production rate (36.4% vs. 0.0%, p=.02). Among patients without bacteremia, the main clinical syndrome was polymicrobial head and neck infections (47.2%).
Conclusions
Human-oral associated Capnocytophaga bacteremia occurs primarily in immunocompromised patients, particularly those with hematologic malignancy. In contrast, C. canimorsus bacteremia is more likely to present with community-onset infection related to zoonotic exposure. Human-oral associated Capnocytophaga infection without bacteremia is frequently isolated in polymicrobial infection; this phenomenon's significance is yet to be fully understood.