Service de Microbiologie, Hôpital Necker-Enfants Malades, Paris, France.
Eur J Clin Microbiol Infect Dis. 2013 Sep;32(9):1111-20. doi: 10.1007/s10096-013-1866-0. Epub 2013 Apr 5.
We report on six cases of Pasteurella multocida (P. multocida) meningitis occurring between 2001 and 2011 by a French nationwide active surveillance network of paediatric bacterial meningitis (ACTIV/GPIP). The cases accounted for 0.15 % of the paediatric meningitis cases reported between 2001 and 2011 in France, all in infants <4 months old. A review of the literature allowed us to gather information on 42 other cases of P. multocida meningitis in infants <1 year old reported since 1963. Among all 48 cases, 44 % were newborns. An animal source of the infection, including 39 household dogs and cats, was suspected or identified in 42 of 48 cases. A traumatic contact between the child and a pet occurred in 8 % of cases, and a vertical transmission from mother to child during birth in 10.4 %. Most of the time, the infection resulted from non-traumatic contact between the child and the pet, through licking or sniffing. The absence of host risk factors suggests that an immature immune system is responsible, given the young age of the children. Although complications, especially neurological lesions, were not rare (37.5 %), the long-term outcome was usually good. Four infants died of meningitis. This rare disease could be prevented by reducing contact between infants and household pets, and by performing simple hygiene measures before handling babies.
我们报告了 6 例多杀巴斯德菌(Pasteurella multocida,P. multocida)脑膜炎病例,这些病例发生在 2001 年至 2011 年期间,由法国一个针对儿童细菌性脑膜炎的全国性主动监测网络(ACTIV/GPIP)报告。这些病例占 2001 年至 2011 年期间法国报告的儿童脑膜炎病例的 0.15%,均发生在<4 个月大的婴儿中。通过对文献的回顾,我们收集了自 1963 年以来报告的 42 例其他<1 岁婴儿多杀巴斯德菌脑膜炎病例的信息。在所有 48 例病例中,44%为新生儿。在 48 例病例中,有 42 例怀疑或确定感染源来自动物,包括 39 只家养狗和猫。在 8%的病例中,儿童与宠物之间发生了创伤性接触,在 10.4%的病例中,感染是通过母婴垂直传播的。大多数情况下,感染是由于儿童与宠物之间的非创伤性接触而发生的,例如宠物舔舐或嗅探儿童。由于儿童年龄较小,因此没有宿主危险因素,提示免疫系统不成熟导致了这种感染。尽管并发症,尤其是神经系统损伤并不少见(37.5%),但长期预后通常良好。有 4 名婴儿死于脑膜炎。这种罕见疾病可以通过减少婴儿与家庭宠物的接触,以及在接触婴儿前采取简单的卫生措施来预防。