Gautier-Lerestif A-L, Desbordes L, Gaillot O, Avril J-L
Laboratoire de bactériologie-virologie, CHRU Pontchaillou, rue Henri Le Guilloux, 35033 Rennes cedex 9.
Ann Biol Clin (Paris). 2003 Jan-Feb;61(1):15-21.
The circumstances of diagnosis of human pasteurellosis are reviewed. The diagnosis is usually suspected for animal bite or scratch wounds. Conversely, in other infections the diagnosis is only based on bacteriological data. Phenotypic misidentification of Pasteurellaceae from clinical material is common. The phenotypic criteria of identification of the six species of human pathogen Pasteurella are presented. We emphasise that bite wound specimens have to be cultured for aerobic and anaerobic bacteria and yield an average of 5 bacterial isolates per culture. Antibiotic therapy relies upon amino-penicillins or cephalosporins, although b-lactamase producing strains are scarce. Fluoroquinolones can be an alternative for systemic infections. Molecular typing unequivocally points out the risk of transmission from pets to humans. Immunocompromised persons have to be made aware of precautions.
本文综述了人类巴斯德氏菌病的诊断情况。诊断通常怀疑与动物咬伤或抓伤伤口有关。相反，在其他感染中，诊断仅基于细菌学数据。从临床材料中对巴斯德氏菌科进行表型错误鉴定很常见。文中介绍了六种人类病原体巴斯德氏菌的表型鉴定标准。我们强调，咬伤伤口标本必须同时培养需氧菌和厌氧菌，每次培养平均得到5株细菌分离株。抗生素治疗依赖于氨基青霉素或头孢菌素，尽管产β-内酰胺酶的菌株很少见。氟喹诺酮类药物可作为全身感染的替代药物。分子分型明确指出了从宠物传播给人类的风险。必须让免疫功能低下的人了解预防措施。
