Flavonifractor plautii: A Rare Pathogen in Sepsis and Critical Care – A Systematic Review of Literature. Meta-data from Covidence.

ABSTRACT

Background

Sepsis, a leading cause of morbidity and mortality, is commonly caused by bacterial infections. Flavonifractor plautii (F. plautii) is a rare anaerobic, gram-positive rod bacterium that forms part of the human intestinal microbiota. 
Objective
This narrative review examines clinical manifestations, diagnostic approaches, and treatment strategies associated with F. plautii infections, focusing on its role as a potential pathogen in sepsis. The goal is to inform clinical decision-making for physicians treating patients with infections, especially in an emergency and critical care settings. 
Methods
The investigators conducted a systematic search of PubMed, Medline and Embase databases to identify case reports and cohort studies involving F. plautii. A total of eleven case reports were identified and investigated. The findings were reviewed to assess patient characteristics, diagnostic methods, antibiotic treatment, and clinical outcomes.
Results
A wide range of comorbidities were noted, with immunocompromised patients dominating. The average age was 56 years. Most infections were from intestinal origin, commonly presenting as sepsis. Intensive care unit management was required in seven of the eleven case reports. In all the cases, the agent was cultured in blood, and in some reports, additionally cerebrospinal-, pleural- and synovial fluid. Antibiotic therapy varied, with meropenem and metronidazole most commonly used, despite antibiotic resistance was rare. All patients were discharged from the hospital alive. 
Conclusions
F. Plautii, although rarely isolated, should be considered potential pathogen in immunocompromised patients with abdominal infections and sepsis conditions. This review illustrates its ability to cause severe septic shock. No specific treatment recommendations beyond current sepsis guidelines were identified.  

Keywords

Sepsis, intensive care unit, infection, bacteria, anaerobe gram-positive