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[Bacteremia due to Pasteurella spp.: a rare process in our hospital over the last 8 years].

OBJECTIVES: To review and update the epidemic and clinical knowledge concerning disseminated blood disease caused by Pasteurella species in our area. METHODS: Retrospective study of Pasteurella species bacteremia (PSB) episodes occurring in patients attended from January 1994 to December 2001 in a single tertiary hospital. RESULTS: Among the 31 clinical samples remitted to the Microbiology Laboratory in which a species of Pasteurella was identified, 5 (16%) corresponded to positive blood cultures in 5 patients. Pasteurella multocida was the predominant species, identified in 70% of all isolations and all but one positive blood culture. All the patients were adults over 50 years old and all had underlying illnesses causing comorbidity or some degree of immunocompromise, with cardiovascular and hypertensive conditions being the most frequent; only one patient had liver cirrhosis. In all cases, except one, contact or coexistence with dogs or cats was documented. The clinical presentation of PSB was non-specific and only two episodes were related with a possible focal, soft-tissue origin. There were no serious complications, such as septic shock, organ failure or invasive disease (meningitis or endocarditis). All patients cured with antimicrobial treatment, although surgical debridement of infected bite wounds was required in two cases. The betalactams and other families of antibiotics showed excellent in vitro activity against the five strains of Pasteurella isolated. CONCLUSIONS: PSB occurred in adult patients having a wide range of underlying illnesses and comorbidity factors. Most of them had contact with pets, though traumatic lesions were not present in all cases. Clinical presentation did not differ from other types of severe sepsis. Susceptibility and outcome of primary treatment with penicillins and other betalactams shows that they are still appropriate therapy. More emphasis should be placed on preventive measures related to care and hygiene among individuals with pets.

Aged↗

Fatal Pasteurella dagmatis peritonitis and septicaemia in a patient with cirrhosis: a case report and review of the literature.

Pasteurella species cause zoonotic infections in humans. Human pasteurella infections usually manifest as local skin or soft tissue infection following an animal bite or scratch. Systemic infections are less common and are limited to patients at the extremes of age or those who have serious underlying disorders, including cirrhosis. Most human pasteurella infections are caused by the multocida species. We report a case of Pasteurella dagmatis peritonitis and septicaemia in a patient with cirrhosis. The infection followed a scratch inflicted by a pet dog. Despite appropriate antibiotic treatment the infection proved fatal. Spontaneous bacterial peritonitis caused by P dagmatis has not been reported previously. Pasteurella dagmatis is a relatively recently described species, which is rarely reported as a human pathogen. This species may be misidentified unless commercial identification systems are supplemented by additional biochemical tests.

Animals↗

[Amino acid metabolism in Pasteurella multocida studied using thin-layer chromatography].

Amino asid metabolism was studied by thin layer chromatography in 25 Pasteurella multocida strains isolated from various manifestations of the disease chicken septicemia. Six amino acids were used: DL-ornithin, L-cystein, L-asparagin, DL-serin, L-arginin and Acidum glutaminicum. The Pasteurella strains studied include in their metabolism the amino acid asparagin, but serin and cystein are excluded. The strains isolated from birds suffering from acute and atypical septicemia do not metabolize ornithin, while these isolated from birds having wattles oedema or from calves suffering from arthritis metabolize it. The reaction of Pasteurellae to arginin and glutamic acid varies and no regularity in this respect is observed. Strains isolated from calves suffering from bronchopneumonia do not include in their metabolism any one of the named amino acids. As a result of the test applied a correlation between the Pasteurella multocida biotypes assessed by the authors and the amino acid metabolism was established. This is one proof more that the isolated pasteurellae can be groupped in two big biotypes by the tests for virulence in birds and including in their metabolism the amino acid ornithin.

Amino Acids↗

Phenotype and serotype of Pasteurella multocida isolates from diseases of dogs and cats in Zimbabwe.

A variety of disease manifestations, comprising skin bite wounds, pyothorax, respiratory and genitourinary tract infections, in 202 dogs and cats presented to the University Clinic, were investigated for the presence of Pasteurella multocida. Of these, 25-42% of various cases (69) were found to be infected with P. multocida. P. multocida-associated respiratory tract infections were more common than bite wounds or genitourinary tract infections. The regimen of treatment consisted of those antibiotics, sensitivity to which had been confirmed in vitro. Following detailed characterization of the isolates of P. multocida, in order to assign them to the reclassified taxa of Pasteurella, a preponderance of P. multocida subspecies multocida and septica were recorded. There did not appear to be a correlation between the reclassified taxa and their serotypes. Certain strains of different species or subspecies belonged to a common serotype and vice versa. However, the strains which were serotyped belonged to capsular type A, except for a solitary isolate from a cat which was capsular type D. Type D is known to cause atrophic rhinitis and does not appear to have been isolated either from a dog or a cat. Two strains, one from a dog and another from a cat, were identified as group EF-4 bacteria. This group of organisms has been incriminated in human wounds resulting from dog/cat bites, and has so far not been reported in Africa. Three different species, P. stomatis, P. dagmatis and P. multocida subspecies multocida were simultaneously isolated from a case of chronic bronchitis in a dog. There was no evidence of any relationship between disease manifestation in a host and the isolation of a particular taxon of Pasteurella, except that P. canis and Pasteurella taxon 16 were only isolated from dogs.

Animals↗

Extracellular neuraminidase production by Pasteurella species isolated from infected animals.

A total of 721 field isolates of various Pasteurella species (haemolytica, multocida, and testudinis) from various regions of the United States were examined for extracellular neuraminidase production. All strains were grown and tested in the same way. Included were 372 P. haemolytica serotype 1 isolates, 181 P. haemolytica serotype 2 isolates, 63 P. haemolytica serotype 6 isolates, 101 Pasteurella multocida isolates, and 4 Pasteurella testudinis isolates. All Pasteurella species examined produced the enzyme. The data revealed the following: (1) Several transfers of P. haemolytica strains on blood agar medium did not cause a decrease in enzyme activity. (2) P. haemolytica serotypes 2 and 6 produce more neuraminidase than P. haemolytica serotype 1, P. multocida, and P. testudinis isolates. (3) There was no apparent change in neuraminidase production by P. haemolytica serotypes 1 and 2 obtained from the same animal taken on different days in the feedyard. (4) There was no significant change in neuraminidase production by P. haemolytica serotype 2 isolates taken from the same animal at the auction market and later at the feedyard.

Animals↗

Species identification and serotyping (capsular antigen) of Pasteurella strains from sheep flocks in south Germany and in Syria.

135 Pasteurella strains were cultivated from nasal swabs of sheep as well as pneumonic lungs of dead and slaughtered sheep. The specimen originated from 41 flocks in South Germany and from 15 flocks and 60 slaughter sheep in Syria (Hama region). Serovariety A2 prevailed amongst P. haemolytica strains (6) isolated in South Germany (53 strains) and in Syria (41 strains). In addition 10 further serovarieties were identified in South Germany (next frequent were A8, A1 and A6) and 7 in Syria. Untypable strains appeared to be more frequent in Syria. Other Pasteurellae (17) represented 1/4 of isolates in Syria and 1/3 of isolates in South Germany. Species identification resulted in P. multocida ssp. multocida (25), P. multocida ssp. septica (4 strains, Syria only), P. canis (3 strains, South Germany only) and Pasteurella-like strains (9 strains). Twelve P. multocida ssp. multocida strains carried capsular antigen D and 7 capsular antigen A. In most cases where multiple samples were examined from one flock, strains with different capsular antigens and/or belonging to different Pasteurella species were isolated (max. 8).

Animals↗

[Studies on respiratory infection with Pasteurella multocida].

A questionnaire style survey on Pasteurella multocida infection was conducted at on 528 laboratories of hospitals. The questionnaire included the detection of Pasteurella multocida from sputum, the age distribution, underlying disease etc. of the patients. In Japan, infectious diseases caused by Pasteurella multocida were found in 179 cases in 67 (26.0%) of the 258 hospitals. The incidence of the infections tends to increase, 18 cases in 1989, 25 cases in 1990, 18 cases in 1991 (Jan.-Jul.). These 179 cases were broken down into 44 males (from 1 year old to 85 years old, mean 58.9 years old), 45 females (from 18 years old to 85 years old, mean 60.2 years old), and 90 patients whose sex was unknown. Underlying diseases were recognized in 72 cases. Diseases related to the respiratory organ were 61 (84.7%) cases. The cases of hemo-sputum had to be differentiated from malignant tumors Recurrent Pasteuralla multocida infections were recognized in 4 males and 4 females. And the 4 cases had been handling animals. There were only 26 cases who had contact with animals, the others were unknown. This result suggested that contact with animals may cause these infections. Recently, the detection of Pasteurella multocida from the sputum tends to increase. The elderly patient with chronic pulmonary disease, who is handling animals must be educated on hygiene and zoonosis.

Adolescent↗

[Current status of Pasteurella multocida infection in Japan].

Recently, the case reports of Pasteurella multocida infection has been increasing in Japan. In 1989, the Japanese Government, Veterinary Sanitation Division, Ministry of Health and Welfare officially communicated this infection as a zoonosis to related institutions. The current status of Pasteurella multocida infection is not well known in Japan. Because of this, a nation wide questionnaire survey on Pasteurella multocida was conducted to clarify the status. A questionnaire was sent to 380 laboratories of the hospitals, and 258 (67.9%) replied. An infectious disease caused by Pasteurella multocida was found in Japan in 369 cases in 115 (44.6%) of 258 hospitals, or an average of 3.2 cases per hospital. The 369 cases were broken down into 123 males (from 1 month old to 87 years old), 118 females (from 7 months old to 88 years old), and 128 patients whose sex was unknown. The incidence of the infections tends to increase year by year. This incidence is higher than our expectation. It is considered that the contact with pets will in increase the infection with this agents. The organism was isolated in as many as nineteen different body specimens, including the appendix and urine, which in Japan has not been reported as organs harboring this organism. Some of the nineteen cases were severely infected. This organism was isolated most often from the sputum (48.5%). Pus was the next most common site (27.1%). This order was reversed in the U.K. and the U.S.. Possible explanations for the reversal are given below.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Morphology, physiology, and serology of a Pasteurella species pathogenic for white perch. (Roccus americanus).

The Pasteurella species implicated as the etiologic agent of a massive white perch mortality in the Chesapeake Bay and first described by S. F. Snieszko et al. has been characterized further in our laboratory. The general morphology and physiology of this organism is similar to that of the pasteurellae and several known fish pathogens. There are enough dissimilarities, however, to rule out its identification with any established species. The organism is obligately halophilic and grows in a temperature range between 17 and 31 C on ordinary media containing 1% NaCl. It has a relatively narrow range of pH, temperature, and salinity tolerance, and a very short survival time in spent media or brackish water, in contrast to Pasteurella pestis and P. pseudotuberculosis. Serological tests also indicate that this organism is distinct from other species which it resembles. On the basis of classic morphological and physiological criteria, this organism fits best in the genus Pasteurella; the species name piscicida (L. noun piscis, a fish; L.v.L.adj. suffix-cidus, to kill; M.L. noun piscicida, fish killer) is proposed.

Animals↗

Isolation of Pasteurella ureae from reproductive tracts of congenic mice.

Infertility noted in two congenic strains of mice was associated with abortion, metritis, and stillbirths. Pasteurella pneumotropica was recovered from affected uterine tracts of ATL mice. Tetracycline treatment for 6 weeks was instituted in an attempt to minimize Pasteurella-associated infertility. Nine ATL mice and 12 ATH mice were examined 4 and 12 months after cessation of tetracycline therapy, respectively. Histopathologically, all animals appeared normal. P. pneumotropica was recovered from six of nine prepuces of both ATH and ATL mice; similarly, two of three vaginal culture of the ATL mice yielded this bacterium. Pasteurella ureae was isolated from three of eight reproductive tracts of the female ATH mice, Negative indole and ornithine decarboxylase reactions and positive acid production for mannitol differentiated P. ureae from P. pneumotropica. This report represents the first confirmed isolation of P. urea from animals. Biochemical profiles of atypical strains of P. pneumotropica isolated from animals are discussed and compared with those of P. ureae. The need for careful biochemical characterization of all Pasteurella isolated from rodents is emphasized.

Animals↗

Coronavirus and Pasteurella infections in bovine shipping fever pneumonia and Evans' criteria for causation.

Respiratory tract infections with viruses and Pasteurella spp. were determined sequentially among 26 cattle that died during two severe epizootics of shipping fever pneumonia. Nasal swab and serum samples were collected prior to onset of the epizootics, during disease progression, and after death, when necropsies were performed and lung samples were collected. Eighteen normal control cattle also were sampled at the beginning of the epizootics as well as at weekly intervals for 4 weeks. Respiratory bovine coronaviruses (RBCV) were isolated from nasal secretions of 21 and 25 cattle before and after transport. Two and 17 cattle nasally shed Pasteurella spp. before and after transport, respectively. RBCV were isolated at titers of 1 x 10(3) to 1.2 x 10(7) PFU per g of lung tissue from 18 cattle that died within 7 days of the epizootics, but not from the lungs of the remaining cattle that died on days 9 to 36. Twenty-five of the 26 lung samples were positive for Pasteurella spp., and their CFU ranged between 4.0 x 10(5) and 2.3 x 10(9) per g. Acute and subacute exudative, necrotizing lobar pneumonia characterized the lung lesions of these cattle with a majority of pneumonic lung lobes exhibiting fibronecrotic and exudative changes typical of pneumonic pasteurellosis, but other lung lobules had histological changes consisting of bronchiolitis and alveolitis typical of virus-induced changes. These cattle were immunologically naive to both infectious agents at the onset of the epizootics, but those that died after day 7 had rising antibody titers against RBCV and Pasteurella haemolytica. In contrast, the 18 clinically normal and RBCV isolation-negative cattle had high hemagglutinin inhibition antibody titers to RBCV from the beginning, while their antibody responses to P. haemolytica antigens were delayed. Evans' criteria for causation were applied to our findings because of the multifactorial nature of shipping fever pneumonia. This analysis identified RBCV as the primary inciting cause in these two epizootics. These viruses were previously not recognized as a causative agent in this complex respiratory tract disease of cattle.

Animals↗

Three cases of acute mesenteric lymphadenitis due to Pasteurella pseudotuberculosis.

Seventeen cases of mesenteric adenitis were investigated between May and October, 1959, for the presence of virus as well as for evidence of Pasteurella pseudotuberculosis infection. Specimens examined included mesenteric glands, appendix, throat swab, faeces, and serum, although glands were received from only 12 patients. Virus was not isolated from any of the specimens, but evidence of infection with Pasteurella pseudotuberculosis was obtained in three patients. The three cases of acute mesenteric lymphadenitis due to Pasteurella pseudotuberculosis are reported. Pasteurella pseudotuberculosis Type IA was isolated from the mesenteric glands of two of the cases, and all three cases showed serological evidence of infection with the organism. The mesenteric glands of two of the cases showed histological changes characteristic of pseudotuberculosis.

Acute Disease↗

In vitro and in vivo activity of 3-(1-methyl 1-5-nitro-2-imidazolylmethylideneamino)-2-oxazolidinone against Pasteurella.

Furazolidone was more active than 3-(1-methyl)-5-nitro-2-imidazolyl-methylideneamino)-2-oxazolidinone (MABN) against a series of 34 isolates of Pasteurella and 11 of Yersinia (formerly designated Pasteurella). However, the nitroimidazole was superior to furazolidone by both subcutaneous and oral routes against a series of mouse infections incited by strains of Pasteurella. It also was superior to furazolidone and sulfaquinoxaline when administered in the diet against two Pasteurella strains in a fowl cholera model infection in chickens. The good in vitro activity of MABN plus its low toxicity suggest its further study as an agent for fowl cholera and the shipping fever complex of cattle.

Animals↗

Colonization of the pharyngeal tonsil and respiratory tract of the gnotobiotic pig by a toxigenic strain of Pasteurella multocida type D.

Seven-day-old gnotobiotic pigs were inoculated intranasally with Pasteurella multocida and euthanatized 2, 5, 9, and 14 days after inoculation. Tissues from the oropharynx and respiratory tract of pigs were cultured quantitatively and analyzed microscopically. Pigs remained afebrile and alert, except one that died of acute fibrinopurulent pneumonia. Pasteurella multocida was isolated in greatest numbers from the pharyngeal tonsils, but only in low numbers from turbinate, trachea, lung, spleen, and liver. Significant histologic changes were limited to the tonsil. Infected pigs developed mild tonsillitis with lymphocytic hyperplasia, and accumulation of cell debris and bacteria in crypts. Capsular antigens of P. multocida, identified on tissue sections with rabbit anti-capsular polysaccharide antibody and immunocytochemical reagents, were confined to the crypt lumen. Ultrastructurally, bacteria were free within crypt material or within phagosomes of macrophages or neutrophils. In a second experiment, 5-day-old pigs were infected with Streptococcus suis type 2, followed by toxigenic Pasteurella multocida at 7 days of age; one pig died of streptococcal septicemia. Pigs developed a mild tonsillitis, and both bacteria were cultured from the tonsillar crypts for up to 14 days after infection. These studies show that a toxigenic strain of Pasteurella multocida, which is a causative agent of atrophic rhinitis, can colonize the tonsil and respiratory tract of gnotobiotic pigs for up to 14 days. In addition, colonization can occur concurrently with Streptococcus suis type 2.

Animals↗

Use of a polymerase chain reaction method to detect the leukotoxin gene lktA in biogroup and biovariant isolates of Pasteurella haemolytica and P trehalosi.

OBJECTIVE: To determine whether Pasteurella haemolytica and P trehalosi isolates possess the structural gene for Pasteurella leukotoxin lktA and whether beta-hemolytic activity of these isolates correlated with detection of the lktA gene. SAMPLE POPULATION: 147 P haemolytica isolates from 21 biovariant groups and 101 P trehalosi isolates from 7 biovariant groups. In addition, P multocida and organisms from 7 other genera were tested to establish specificity of the procedure. PROCEDURE: Isolates were observed for beta-hemolysis. A polymerase chain reaction (PCR) procedure was used to amplify the RTX domain of the Pasteurella lktA gene. RESULTS: The lktA gene was detected in 108 (44%) isolates, including 15 associated with respiratory tract disease. All but 2 (98%) of the isolates that had the lktA gene were beta-hemolytic when grown on sheep blood agar. The remaining 140 isolates were negative for the lktA gene and hemolytic activity. CONCLUSIONS AND CLINICAL RELEVANCE: Hemolytic activity of P haemolytica and P trehalosi isolates correlated with detection of the lktA gene for all but 2 isolates. However, 56% of isolates tested were negative for the lktA gene and beta-hemolytic activity. Leukotoxin production and secretion is a major virulence factor when other conditions are favorable for disease development. Therefore, identification of strains that possess the lktA gene may aid in the evaluation of the pathogenic potential of Pasteurella strains carried by wild and domestic animals.

Animals↗

Antibacterial efficacy and pharmacokinetic studies of ciprofloxacin on Pasteurella multocida infected rabbits.

Twenty four isolates of Pasteurella multocida were taken from 74 diseased rabbits which suffered from respiratory manifestations with an incidence 35.1%. All isolated strains were identified biochemically and serologically as Pasteurella multocida type 3. The in vitro sensitivity test proved that Ciprofloxacin was the most effective antibiotic which was used for treatment of diseased rabbits. There was no isolation of Pasteurella multocida organism from all treated rabbits with Ciprofloxacin which can eliminate the causative organism, and control the infection within the examined rabbit colony. The kinetics of Ciprofloxacin, a fluoroquinolone, was studied after multiple oral and I/V dose of 20 mg/kg b. wt. In healthy rabbits and in those diseased with Pasteurella multocida Ciprofloxacin was given at a dose (20 mg kg-1/day) orally for successive 5 days. Serum levels reached their peak Tmax, at 2.321 and 2.524 hrs. in healthy and infected rabbits after oral administration, with absorption half-life (t0.5 (ab)) of 1.22 and 2.41 hrs. and elimination half-life (t0.5 (B)) of 2.24 and 1.28 hour respectively. Following I/V injection the kinetics of Ciprofloxacin follow two compartment model with (t0.5 (B)) 1.201 and 0.82 hour for normal and infected rabbits, (Vd (area)) of 0.653 and 0.563 L/kg and total body clearance CL(B) of 0.385 and 0.358 L/kg/hr respectively. High tissue concentrations of the drug were recorded in the kidneys, lung, spleen, liver, and muscle of diseased rabbits, while in healthy animal group the highest concentrations were achieved in kidney, liver, lung, spleen, and muscle. The high Ciprofloxacin tissue concentrations indicate that the Ciprofloxacin may be an excellent drug for treating urinary and respiratory tract infections.

Administration, Oral↗

Prevalence and characteristics of Pasteurella multocida in commercial turkeys.

The oropharyngeal regions of 680 meat turkeys and 55 breeder turkeys from nine outbreak farms, three history-outbreak farms, and 19 nonoutbreak farms in Ohio, Indiana, and Pennsylvania were cultured to determine the prevalence of Pasteurella multocida in turkeys. Pasteurella multocida was recovered from 32 out of 105 turkeys belonging to outbreak farms. Pasteurella multocida was not recovered from either history-outbreak or nonoutbreak farms. Characterization via capsular and somatic serotyping, biotyping, restriction endonuclease analysis, and antimicrobial susceptibility testing was performed on all recovered P. multocida isolates. Pasteurella multocida serotype A:1 and somatic serotype 1 with an un-typable capsular serogroup (UT:1) were the most common serogroups found. All isolates belonged to biotype P. multocida ssp. multocida. EcoRI, HpaII, and HindIII restriction enzyme digestions identified three, five, and five restriction fragment length polymorphism profiles, respectively. A majority of the isolates were susceptible to amikacin, ampicillin, ceftiofur, cephalothin, enrofloxacin, florfenicol, gentamicin, neomycin, novobiocin, oxacillin with 2% NaCl, sarafloxacin, tilmicosin, and trimethoprim with sulphadiazine and resistant to clindamicin, penicillin, tiamulin, and tylosin.

Animal Husbandry↗

Safety and efficacy of a streptomycin dependent live Pasteurella multocida vaccine in rabbits.

The safety of and protection provided by a streptomycin dependent live Pasteurella multocida (serotype 12:A) vaccine was evaluated in New Zealand white rabbits. The vaccine strain was isolated from two of twelve rabbits 24 hours after intranasal administration. Streptomycin independent P. multocida isolates were not recovered for 4 weeks after vaccination, indicating a lack of reversion to the wild type. Thirty days after a single intranasal administration of vaccine, eight rabbits were challenged with either P. multocida serotype 3:A or serotype 12:A. Eight non-vaccinated rabbits were challenged in the same manner. Vaccinated rabbits challenged with serotype 12:A had nasal infections for only 2 weeks following challenge. Vaccinated rabbits challenged with serotype 3:A developed chronic nasal infections but were protected from severe disease. Immunoglobulin A or G antibodies against P. multocida were not detected after vaccination in nasal lavages or sera using an enzyme-linked immunosorbent assay. However, both antibodies increased following challenge with either serotype 3:A or serotype 12:A. These studies indicated that the streptomycin dependent pasteurella strain colonized rabbits briefly and was genetically stable in vivo. The results in challenged rabbits suggest that the vaccine provided protection against chronic infection by a homologous pasteurella serotype and protection against severe disease by a heterologous pasteurella serotype.

Animals↗