Fulminant Septic Shock with Pasteurella multocida in a Young Infant: No Bite, Scratch, or Lick!

This is a case of Pasteurella multocida septic shock encountered in a 7-week-old infant without any bites, scratch marks, or history of licks by pet animals (dog and cats in household). The infant required 3 days of vasopressor support and 4 days of mechanical ventilation to achieve normal hemodynamics. This is an unidentified route of transmission and our literature search for this topic discovered reported cases of life-threatening presentation with Pasteurella infections in the absence of a bite or any form of invasive contact with animals. We believe that this is an important public safety message to restrict animal contact of young infants to prevent severe infection.

Pasteurella multocida Infections with Unusual Modes of Transmission from Animals to Humans: A Study of 79 Cases with 34 Nonbite Transmissions.

Pasteur discovered the causative agent of fowl cholera (Pasteurella multocida) in 1880. Since then, multiple zoonotic infections affecting humans have been reported. P. multocida infections usually result from bites of cats or dogs. The earliest reports of nonbite transmissions (NBTs) were attributed to cat scratches and lung colonization. More recently, multiple modes of unusual NBTs have been reported, including animal exposures with no direct contact. Here, we report 79 cases of pet-associated infections, with 34 NBTs. Previously unreported and unsuspected, novel modes of NBTs presented include stepping on dog drool infecting a submetatarsal ulcer, contamination of a wound by socks covered with cat hair and dander resulting in P. multocida bacteremia, stumbling over a dog and falling while drunk and abrasions contaminated with dog saliva resulting in wound infection, and severe epiglottitis and supraglottitis after eating peanut butter and crackers half eaten by a dog. Cat bites were more common than dog bites. Both bite and nonbite infections were more common in the elderly, with more older patients in the nonbite group. Upper extremity bites were more than lower extremity bites for both cats and dogs. NBTs were associated with more co-morbidities and resulted in more life-threatening infections than bites, confirming the findings of a prior smaller series. Open wounds were the most common point of entry for nonbite infections, with majority in the lower extremity. Based on this study and prior reports, pet owners must protect open wounds and individuals with certain underlying conditions and infants should avoid pet exposure completely. Our findings and animal transmission of bite and nonbite P. multocida infections reported in literature are summarized.

Pathogenomics insights for understanding Pasteurella multocida adaptation.

Pasteurella multocida is an important veterinary pathogen able to infect a wide range of animals in a broad spectrum of diseases. P. multocida is a complex microorganism in relation to its genomic flexibility, host adaptation and pathogenesis. Epidemiological analysis based on multilocus sequence typing, serotyping, genotyping, association with virulence genes and single nucleotide polymorphisms (SNPs), enables assessment of intraspecies diversity, phylogenetic and strain-specific relationships associated with host predilection or disease. A high number of sequenced genomes provides us a more accurate genomic and epidemiological interpretation to determine whether certain lineages can infect a host or produce disease. Comparative genomic analysis and pan-genomic approaches have revealed a flexible genome for hosting mobile genetic elements (MGEs) and therefore significant variation in gene content. Moreover, it was possible to find lineage-specific MGEs from the same niche, showing acquisition probably due to an evolutionary convergence event or to a genetic group with infective capacity. Furthermore, diversification selection analysis exhibits proteins exposed on the surface subject to selection pressures with an interstrain heterogeneity related to their ability to adapt. This article is the first review describing the genomic relationship to elucidate the diversity and evolution of P. multocida.

Peritonitis Secondary to Uncommon Gram-Negative Coccobacillus Transmitted From a Cat in a Patient on Peritoneal Dialysis.

Peritonitis caused by gram-negative organisms is a significant complication encountered in patients undergoing peritoneal dialysis and is associated with high morbidity and mortality. There has been recognition of peritonitis caused by uncommon organisms because of improved microbiological detection techniques. In this article, we report a rare case of peritonitis caused by Pasteurella multocida. We present a 58-year-old male on peritoneal dialysis with fever and abdominal pain. The peritoneal fluid was cloudy, and the analysis was consistent with peritonitis. The peritoneal fluid culture grew Pasteurella multocida. The patient was treated with a 3-week course of intraperitoneal ceftazidime, which resulted in the resolution of infection with the salvation of the peritoneal dialysis catheter. Patient education plays a very critical role in the prevention of peritonitis from Pasteurella multocida, particularly if patients have pets at home. The domestic pets should be kept away from the dialysis equipment and should not be allowed into the room during dialysis treatment. Incorporating the education in handing pets during the training session is the key aspect.

Novel insights into pasteurellosis in captive pinnipeds.

Pasteurella multocida is a heterogeneous bacterium, which has the capacity to cause disease in a wide range of host species and is also recognized as an important zoonotic pathogen. Two sequential deaths in captive fur seals occurred at Sea World, Australia during December 2017. A fibrinosuppurative bronchopneumonia in a Subantarctic fur seal (Arctocephalus tropicalis) resulted in death within 24 h of nonspecific signs of illness, whereas a septic peritonitis in a New Zealand fur seal (Arctocephalus forsteri) resulted in death within 12 h of clinical presentation. The cases happened within three days in two different pool locations, although both had previously been housed in the same area. A total of six Pasteurella multocida isolates were obtained from several internal organs at necropsy in both cases and were subjected to whole genome sequencing and phylogenomic analysis. In-silico typing of the isolates revealed that all belonged to Multi-Locus Sequence Type 7 and carried lipopolysaccharide outer core biosynthesis loci Type 3. Phylogenomic analysis of the isolates confirmed that the isolates were near identical at the core genome level, suggesting acquisition from a common source. The results also revealed the presence of within host and across animal diversity of P. multocida isolates for the first time even in a clearly connected outbreak.

Human Pasteurellosis Health Risk for Elderly Persons Living with Companion Animals.

The necessity for diagnosis and treatment of this infection is emphasized by the high number of complications and death rate.

An unusual case of Pasteurella multocida bacteremic meningitis.

Pasteurella multocida is a rare cause of bacterial meningitis, more frequently affecting humans at the extremes of age. We report a case of meningitis and bacteremia caused by P. multocida in a 67-year-old diabetic woman who was living with 10 cats. She didn't have any animal bites or scratches, but she reported kissing the pets in the mouth. The outcome was favorable following antimicrobial treatment. Although rarely encountered, P. multocida should be considered as a possible cause of meningitis, particularly when Gram-negative coccobacilli are revealed in the cerebrospinal fluid and a history of recent animal contact is present.

Pathogenicity of Pasteurella sp. in lumpsuckers (Cyclopterus lumpus L.).

The incidence of disease caused by Pasteurella sp. in farmed lumpsuckers in Norway has been steadily increasing in recent years, causing significant economic losses and fish welfare issues. The disease affects all life stages, both in hatcheries and after release into salmon cages. Therefore, it is important to establish robust challenge models, to be used for vaccine development. Exposure experiments via intramuscular and intraperitoneal injection underlined the high virulence of the bacteria, whereas the cohabitation and bath models allowed the chronic symptoms of the disease to be studied more accurately. Skin lesions and haemorrhage at the base of fins were observed in the more acute cases of the disease. Symptoms including white spots over the skin, especially around the eyes, characterized the chronic cases. The latter were most prominent from the bath challenge model. Histopathology indicated a systemic pattern of disease, whereas qPCR analysis from head kidney showed that bacteria may be present in survivor fish at the end of the challenges. In all the challenge models investigated, Pasteurella sp. was re-isolated from the fish, thus fulfilling Koch's postulates. These findings highlight the importance of screening of lumpsuckers prior to transfer to minimize the risks of carrying over asymptomatic carriers.

Human Pasteurella multocida Infection with Likely Zoonotic Transmission from a Pet Dog, Spain.

We report a case of urinary tract infection caused by an unusual genotype (sequence type 211) of Pasteurella multocida associated with human infection. Molecular genetic analysis of P. multocida isolates obtained from the human patient and his pet strongly suggests a zoonotic transmission of this bacterium.

Pasteurella aerogenes as an Asymptomatic Bacteriuria Agent.

'Asymptomatic bacteriuria' (ASB) is isolation of a specified quantitative count of bacteria in an appropriately collected urine specimen obtained from a person without symptoms or signs referable to urinary infection. Catheterized specimens are less likely to be contaminated compared with voided specimens; therefore, positive cultures of catheterized specimens are more likely to reflect true bladder bacteriuria even with low colony counts. The common pathogens for ASB are Escherichia coli, Klebsiella and Streptococcus spp. Pasteurella spp. was not previously reported as an ASB agent. ASB is important for pregnant women, children, individuals with obstructive uropathy, chronic renal failure and neutropenia, before the urologic procedures and after renal transplantation. Treatment of ASB is required for above situations. We report an 11-year-old-girl with neurogenic bladder who made clean intermittent catheterization and had Pasteurella aerogenes as an ASB agent.

Ducks as a potential reservoir for Pasteurella multocida infection detected using a new rOmpH-based ELISA.

Pasteurella multocida is an important pathogen of numerous domestic poultry and wild animals and is associated with a variety of diseases including fowl cholera. The aim of this study was to develop an indirect enzyme-linked immunosorbent assay (ELISA) based on recombinant outer-membrane protein H (rOmpH) for detection of anti-P. multocida antibodies in serum to determine their prevalence in Chinese ducks. The P. multocida ompH gene was cloned into pET32a, and rOmpH was expressed in Escherichia coli BL21 (DE3). Western blotting revealed that purified rOmpH was recognized by duck antisera against P. multocida, and an indirect ELISA was established. During analysis of serum samples (n=115) from ducks, the rOmpH ELISA showed 95.0% specificity, 100% sensitivity and a 92.0% κ coefficient (95% confidence interval 0.844-0.997) as compared with a microtiter agglutination test. Among 165 randomly selected serum samples, which were collected in 2015 and originated from six duck farms across Fujian Province, China, anti-P. multocida antibodies were detected in 22.42% of apparently healthy ducks, including 25 of 90 sheldrakes (27.8%), eight of 50 Peking ducks (16.0%) and four of 25 Muscovy ducks (16%). Overall, the data suggest that rOmpH is a suitable candidate antigen for the development of an indirect ELISA for detection of P. multocida in ducks; moreover, our results showed that ducks could serve as a potential reservoir for P. multocida infection.

Aortic Endograft Infection by Pasteurella multocida: A Rare Case.

Infection of an aortic endograft is a rare complication following endovascular aneurysm repair. These patients have been treated with explantation of the graft to obtain source control followed by an extra-anatomic bypass to restore circulation. The present case study describes an interesting case of Pasteurella infection involving an aortic endograft managed nonoperatively by percutaneous drainage and graft preservation.

Injecting epidemiology into population viability analysis: avian cholera transmission dynamics at an arctic seabird colony.

Infectious diseases have the potential to spread rapidly and cause high mortality within populations of immunologically naïve hosts. The recent appearance of avian cholera, a highly virulent disease of birds caused by the bacterium Pasteurella multocida, at remote Arctic seabird colonies is an emerging conservation concern. Determining disease risk to population viability requires a quantitative understanding of transmission potential and the factors that regulate epidemic persistence. Estimates of the basic (R0 ) and real-time (Rt ) reproductive number are critical in this regard - enumerating the number of secondary infections caused by each primary infection in a newly invaded host population and the decline in transmission rate as susceptible individuals are removed via mortality or immunized recovery. Here, we use data collected at a closely monitored common eider (Somateria mollissima) breeding colony located in the Canadian Arctic to examine transmission and host population dynamics. Specifically, we infer epidemic curves from daily mortality observations and use a likelihood-based procedure to estimate changes in the reproductive number over a series of annual outbreaks. These data are interpreted in relation to concurrent changes in host numbers to assess local extinction risk. Consistent with expectations for a novel pathogen invasion, case incidence increased exponentially during the initial wave of exposure (R0  = 2·5; generation time = 6·5 days ± 1·1 SD). Disease conditions gradually abated, but only after several years of smouldering infection (Rt  ≈ 1). In total, 6194 eider deaths were recorded during outbreaks spanning eight consecutive breeding seasons. Breeding pair abundance declined by 56% from the pre-outbreak peak; however, a robust population of >4000 pairs remained intact upon epidemic fade-out. Overall, outbreak patterns were consistent with herd immunity acting as a mitigating factor governing in the extent and duration of mortality. Disease mortality is frequently modelled as a form of stochastic catastrophe in wildlife population assessments, whereas our approach gives shape to the functional response between transmission and host population dynamics. We conclude that increased emphasis on integrating epidemiological and population processes is essential to predicting the conservation impact of emerging infectious diseases in wildlife.

Neonatal Pasteurella multocida subsp. septica Meningitis Traced to Household Cats: Molecular Linkage Analysis Using Repetitive-Sequence-Based PCR.

Pasteurella multocida is a rare cause of neonatal bacterial meningitis. We describe such a case and verify two household cats as the source of infection using repetitive-element PCR (rep-PCR) molecular fingering.

[Invasive Pasteurella multocida infections: Two clinical cases and literature review]. / Invazivní infekce vyvolané Pasteurella multocida: popis dvou prípadu a prehled literatury.

Pasteurella multocida is a common commensal of the gastrointestinal and respiratory tracts of animals, especially cats and dogs. It is transmitted to humans through contact with animals. Bite wound infection is the most common clinical manifestation. Systemic infections are unusual and mainly affect immunocompromised individuals. The article presents two cases of Pasteurella infection. Wound infection in a 75-year-old female following a bite from her pet cat was associated with bacteremia. The disease course was favorable with the initial clindamycin treatment despite in vitro resistance. The other patient was a 62-year-old female diagnosed with acute bacterial meningitis with multiple brain abscesses and transient expressive aphasia. She reported frequent contacts with pets and domestic animals without a recent bite. Hematogenous dissemination of the infection was suspected. Because of poor therapeutic response, cefotaxime was switched to chloramphenicol which was later switched to a combination of cefotaxime with ciprofloxacin due to anemia. Following 6 weeks of intravenous antibiotic therapy and another 10 weeks of oral ciprofloxacin therapy, magnetic resonance imaging showed normal results and the neurological defect resolved. Epidemiological, clinical and therapeutic aspects of Pasteurella infection are discussed and literature is reviewed.