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多杀巴斯德菌感染的临床特征与结局

Clinical Features and Outcomes of Pasteurella multocida Infection.

作者信息

Giordano Antonio, Dincman Toros, Clyburn Benjamin E, Steed Lisa L, Rockey Don C

机构信息

From the Department of Internal Medicine (AG, TD, BEC, DCR); and Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Department of Medicine, Charleston, South Carolina (LLS).

出版信息

Medicine (Baltimore). 2015 Sep;94(36):e1285. doi: 10.1097/MD.0000000000001285.

Abstract

Pasteurella multocida, a zoonotic infectious organism, has most often been described in patients after an animal bite. Here, we characterize the clinical features and outcomes of P multocida infection in a large cohort of patients according to the presence or absence of an animal bite.We retrospectively searched MUSC's laboratory information system for all patients with positive P multocida cultures from 2000 to 2014. Extensive data were abstracted, including clinical and outcome data. The Charlson comorbidity index (CCI) was used to assess comorbidities among patients.We identified 44 patients with P multocida infections, including 25 with an animal bite. The average age was 64 years and the majority of patients were women (N = 30). There was no difference in age and sex distribution among those with and without a bite (P = 0.38 and 0.75, respectively). A CCI ≥1 was significantly associated with the absence of a bite (P = 0.006). Patients presenting without a bite were more frequently bacteremic (37% vs 4%, respectively, P = 0.001), and were hospitalized more often (84% vs 44%, respectively, P = 0.012). Of the 8 patients who required intensive care unit (ICU)-based care, 7 were non-bite-related. There were 4 deaths, all occurring in patients not bitten.P multocida infections not associated with an animal bite were often associated with bacteremia, severe comorbidity(ies), immune-incompetent states, the need for ICU management, and were associated with substantial mortality.

摘要

多杀巴斯德菌是一种人畜共患的感染性生物,最常见于动物咬伤后的患者。在此,我们根据是否存在动物咬伤,对一大群多杀巴斯德菌感染患者的临床特征和转归进行了描述。我们回顾性检索了2000年至2014年MUSC实验室信息系统中所有多杀巴斯德菌培养阳性的患者。提取了大量数据,包括临床和转归数据。采用查尔森合并症指数(CCI)评估患者的合并症情况。我们确定了44例多杀巴斯德菌感染患者,其中25例有动物咬伤史。平均年龄为64岁,大多数患者为女性(N = 30)。有咬伤和无咬伤患者的年龄和性别分布无差异(P分别为0.38和0.75)。CCI≥1与无咬伤显著相关(P = 0.006)。无咬伤的患者菌血症发生率更高(分别为37%和4%,P = 0.001),住院频率也更高(分别为84%和44%,P = 0.012)。在8例需要重症监护病房(ICU)护理的患者中,7例与咬伤无关。有4例死亡,均发生在未被咬伤的患者中。与动物咬伤无关的多杀巴斯德菌感染常与菌血症、严重合并症、免疫功能不全状态、需要ICU管理相关,且死亡率较高。

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