A series of 16 Pasteurella spp bite wound infections with review of 65 infectious episodes caused by Pasteurella spp and 28 consecutive human and anim

Authors:
Aaron George, Anne Sescleifer, Hugo Bonatti, John Kessler, Junius Rosario

Body of Abstract:
Background: Pasteurella spp (PS) are Gram negative facultative anaerobic rods causing diseases in humans and animals such as cattle, sheep but also elephants. Dogs and cats carry the organism and do not develop disease but may transmit the pathogen to humans especially in case of bite injuries.
Patients and Methods: Our institutional database was searched for all cases of PS infection during a 4-year period. All animal and human bites in which pathogens were identified were analyzed. Sixteen bites in which PS were isolated were compared to 12 bites in which other organisms (staphylococci 6, streptococci 3, Eikenella corrodes 1, Capnocytophaga canimorsus 1, Anaerococcus prevotii 1) were isolated.
Results: 76 isolates of PS in 64 patients (46.9% male) were identified. Median age was 60.7 (range 2.3 to 94.3) years), there were 5 pediatric cases (8%). Rate of DM was 30%, 25% of patients were active smokers. 22% of isolates were from blood cultures, 5% were from drained abscesses, 32% from drained fluid and 33% were from wounds. PS (83% P. multocida, 16% P. canis, 2% P. species) infections were located at head/neck/mouth 5%, trunk 2%, upper extremity 27%, lower extremity, 2% other and 22% blood stream. Bites were the most common single cause of PS infections. Most bites involved the upper extremities (64%), 11 were caused by cats and 10 by dogs and all infections were monomicrobial, however, in 40% additional “normal flora” was reported. Table 1 compares PS and non-PS bites and shows demographic, clinical and microbiology data of all PS infections. PS were more commonly associated with cat bites (50% vs 25%). Treatment consisted of surgical drainage/debridement and antibiotics including Betalactms, Tetracyclines or Fluoroquinolons.
Conclusion: PS account for >50% of all bite associated infections. The pathogen should be covered in empiric therapy of bite associated infections. Of note, PS are capable of causing a variety of other infections.