Flavonifractor plautii: A rare pathogen in sepsis and critical care---A systematic narrative review of literature

BACKGROUND: Sepsis, a leading cause of mortality, is commonly caused by bacterial infections. Flavonifractor plautii is a rare anaerobic, gram-positive rod bacterium that forms part of the human intestinal microbiota. This narrative review aims to summarize patient characteristics, diagnostic approaches, and antibiotic therapy in patients with F plautii infections, with a particular focus on its role as a potential pathogen in sepsis, in order to inform clinical decision-making. METHODS: The investigators conducted a systematic search of PubMed, MEDLINE and Embase databases to identify case reports and cohort studies involving F plautii. RESULTS: A wide range of comorbidities were observed, with immunocompromised patients predominating. Most infections originated from gastrointestinal tract and commonly presented as sepsis. Intensive care unit management was required in 8 of the 11 case reports. In all the cases, the pathogen was isolated from blood cultures, and in some reports additionally from cerebrospinal, pleural and synovial fluid. Antibiotic therapy varied, with meropenem and metronidazole being the most commonly used agents, despite antibiotic resistance was rare. DISCUSSION: F plautii should be considered a potential pathogen in immunocompromised patients presenting with abdominal infections and sepsis. CONCLUSIONS: This review illustrates F plautii`s ability to cause severe sepsis. No specific treatment recommendations beyond current sepsis guidelines were identified.