Subject(s)
Anti-Bacterial Agents/therapeutic use , Bites and Stings/drug therapy , Cats , Pasteurella Infections/drug therapy , Penicillin V/therapeutic use , Wound Infection/drug therapy , Animals , Bites and Stings/complications , Bites and Stings/microbiology , Humans , Pasteurella multocida/isolation & purification , Wound Infection/etiology , Wound Infection/microbiologySubject(s)
Antibodies, Bacterial/blood , Bartonella henselae/immunology , Bites and Stings , Cat-Scratch Disease/epidemiology , Cats/microbiology , Adolescent , Adult , Aged , Aged, 80 and over , Animals , Cat-Scratch Disease/immunology , Cat-Scratch Disease/microbiology , Female , Humans , Male , Middle Aged , Sweden/epidemiology , Young AdultABSTRACT
OBJECTIVE: The rate of infection following cat bites appears to be greater than that from dog bites. To study the clinical picture, complications and microbiology (in humans and cats), this prospective study was performed. METHODS: A prospective study with patients with clinical symptoms of infection due to cat bites from three emergency wards during two years in Stockholm, Sweden. Aerobic and anaerobic cultures from the wounds were performed as well as cultures from the biting cat's mouth. Clinical data and complications were registered. RESULTS: Seventy-nine episodes in 78 patients with infective cat bites were included. Pasteurella multocida was isolated in 70% of the patients; in addition anaerobic pathogens were isolated in 16% concurrently with P. multocida, while Staphylococcus aureus was isolated in only two patients. Pasteurella spp. was also isolated from 80% of the pharynx of the biting cats. The dominating symptoms of infection were erythema, pain and oedema, often emerging as early as 3h after the bite. Complications such as tendosynovitis, arthritis, abscesses and septicaemia occurred in 18% of the patients. No patient died due to the infection. The majority of the patients received penicillin or amoxicillin as antibiotic treatment. CONCLUSIONS: P. multocida was the dominating pathogen among patients with infected cat bites and antibiotic treatment should cover P. multocida.
Subject(s)
Bites and Stings/physiopathology , Cats/microbiology , Pasteurella/isolation & purification , Wound Infection/microbiology , Adolescent , Adult , Aged , Aged, 80 and over , Animals , Anti-Bacterial Agents/therapeutic use , Bites and Stings/drug therapy , Bites and Stings/microbiology , Female , Hospitalization , Humans , Male , Middle Aged , Pasteurella/pathogenicity , Prospective Studies , Sweden , Wound Infection/complications , Wound Infection/drug therapyABSTRACT
To investigate the management of patients with community-acquired pneumonia (CAP) treated in hospital in Sweden, a multicentre retrospective cohort study was performed with medical record review of 982 patients (mean age 63 y) at 17 departments of infectious diseases at hospitals in Sweden. Information on antimicrobial therapy, demographic characteristics, comorbid conditions, physical examination findings, and laboratory and microbiological test results were recorded. Outcome measures were in-hospital mortality and length of hospital stay (LOS). Cultures were obtained from blood in 80% and from sputum in 22% of the patients. A microbiological aetiology was determined for 23% of the patients, with Streptococcus pneumoniae as the dominating agent (9%). The initial antibiotic treatment was mostly given intravenously (78%). Penicillin (50%) or a cephalosporin (30%) was the most common choice. Both of these drugs were usually given as a single agent. The overall mortality was 3.5% and the mean LOS was 6.4 d. Thus, the outcome was favourable despite the empirical antibiotic treatment having a narrow spectrum compared with the broader approach recommended in most recent guidelines on the management of CAP. These findings suggest that a majority of patients who are hospitalized with moderately severe pneumonia can be treated initially with penicillin alone.