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从挪威大鼠和黑家鼠同种咬伤伤口分离出的细菌:对人类鼠咬相关感染的影响。

Bacteria isolated from conspecific bite wounds in Norway and black rats: implications for rat bite-associated infections in people.

作者信息

Himsworth Chelsea G, Zabek Erin, Tang Patrick, Parsons Kirbee L, Koehn Martha, Jardine Claire M, Patrick David M

机构信息

1 School of Population and Public Health, University of British Columbia , Vancouver, British Columbia, Canada .

出版信息

Vector Borne Zoonotic Dis. 2014 Feb;14(2):94-100. doi: 10.1089/vbz.2013.1417.

Abstract

Bites associated with wild and domestic Norway and black rats (Rattus norvegicus and Rattus rattus) may have a variety of health consequences in people. Bite-related infections are among the most significant of these consequences; however, there is little data on the infectious agents that can be transmitted from rats to people through biting. This is problematic because without an accurate understanding of bite-related infection risks, it is difficult for health professionals to evaluate the adequacy of existing guidelines for empirical therapy. The objectives of this study were to increase our knowledge of the bacterial species associated with rat bites by studying bite wounds that wild rats inflict upon one another and to review the literature regarding rat bites and bite wound management. Wild Norway and black rats (n=725) were trapped in Vancouver, Canada, and examined for bite wounds in the skin. All apparently infected wounds underwent aerobic and anaerobic culture, and isolated bacteria were identified. Thirty-six rats had bite wound-related infections, and approximately 22 different species of bacteria belonging to 18 genera were identified. Staphylococcus aureus was the most common isolate; however, the majority of infections (72.5%) were polymicrobial. Rat bites can result in infection with a number of aerobic and anaerobic Gram-positive and Gram-negative bacteria. In humans, these wounds are best managed through early recognition and cleansing. The benefit of prophylactic antimicrobial treatment is debatable, but given the deep puncturing nature of rodent bites, we suggest that they should be considered a high risk for infection. Antibiotics selected should include coverage for a broad range of bacterial species.

摘要

野生和家养的挪威大鼠及黑家鼠(褐家鼠和黑家鼠)造成的咬伤可能给人类带来多种健康后果。与咬伤相关的感染是这些后果中最为严重的;然而,关于可通过咬伤从大鼠传播给人类的病原体的数据却很少。这是个问题,因为如果不能准确了解与咬伤相关的感染风险,卫生专业人员就难以评估现有经验性治疗指南是否充分。本研究的目的是通过研究野生大鼠相互造成的咬伤伤口来增加我们对与鼠咬相关细菌种类的了解,并回顾有关鼠咬及咬伤伤口处理的文献。在加拿大温哥华捕获了725只野生挪威大鼠和黑家鼠,并检查其皮肤的咬伤伤口。所有明显感染的伤口都进行了需氧和厌氧培养,并对分离出的细菌进行了鉴定。36只大鼠有与咬伤伤口相关的感染,共鉴定出约22种属于18个属的不同细菌。金黄色葡萄球菌是最常见的分离菌;然而,大多数感染(72.5%)是多菌感染。鼠咬可导致感染多种需氧和厌氧的革兰氏阳性及革兰氏阴性细菌。对于人类而言,这些伤口最好通过早期识别和清洗来处理。预防性抗菌治疗的益处存在争议,但鉴于啮齿动物咬伤的深部穿刺性质,我们建议应将其视为感染的高风险情况。所选抗生素应涵盖广泛的细菌种类。

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