Northern Territory Department of Health, Territory Pathology, Darwin, Northern Territory, Australia.
PLoS One. 2023 Jan 31;18(1):e0281164. doi: 10.1371/journal.pone.0281164. eCollection 2023.
Acquired zoonotic infections with Pasteurella bacterial species have a wide clinical spectrum of disease from invasive infections to localised bite-wound infections.
This study reviewed the spectrum of the demographic, clinical, temporal, and microbiological trends of laboratory confirmed Pasteurella species infections presenting to a single-centre tropical tertiary hospital over a twenty-year period.
195 episodes from 190 patients were included. 51.3% patients were female, and 20.5% Aboriginal or Torres Strait Islander peoples. Crude incidence of Pasteurella spp. infections increased from 1.5 per 100,000 population in 2000, to 11.4 per 100,000 population in 2021. There were 22 (11.3%) bloodstream infections, 22 (11.3%) invasive, 34 (17.4%) deep local, 98 (50.2%) superficial infections, and 19 (9.7%) other or unknown. Adults over 65 years of age accounted for the majority of bacteraemias (63.7%). More severe infections, including bacteraemia, invasive and deep local infections, were more common in lower limb infections and in those with underlying comorbidities. Animal contact with cats was more common in bloodstream infections (36.4%), but dog bites more common in invasive, deep local and superficial infections. 30-day all-cause mortality was low at 1.0%. Pasteurella multocida was most commonly identified (61.1%), but P. canis, P. dagmatis, and other Pasteurella infections were also noted. 67.7% of specimens were polymicrobial, with other significant organisms being Staphylococcus aureus, Streptococcus pyogenes, Group G Streptococcus and Pseudomonas aeruginosa.
Pasteurella species remain clinically important pathogens, with the ability to cause severe and invasive infections with associated morbidity. Presentations to hospital are becoming more common, and the polymicrobial nature of bites wounds has implications for empiric antibiotic guidelines.
巴氏杆菌属的获得性人畜共患感染具有广泛的临床疾病谱，从侵袭性感染到局部咬伤感染。
本研究回顾了 20 年来在一家单一中心热带三级医院就诊的实验室确诊巴氏杆菌属感染的人口统计学、临床、时间和微生物学趋势的范围。
共纳入 190 名患者的 195 例次。51.3%的患者为女性，20.5%为原住民或托雷斯海峡岛民。巴氏杆菌属感染的粗发病率从 2000 年的每 10 万人 1.5 例增加到 2021 年的每 10 万人 11.4 例。有 22 例（11.3%）血流感染、22 例（11.3%）侵袭性感染、34 例（17.4%）深部局部感染、98 例（50.2%）浅表感染和 19 例（9.7%）其他或未知。65 岁以上的成年人占血培养阳性的大多数（63.7%）。感染下肢和合并基础疾病的患者更易发生严重感染，包括血流感染、侵袭性感染和深部局部感染。与猫接触在血流感染中更为常见（36.4%），而狗咬伤在侵袭性、深部局部和浅表感染中更为常见。30 天全因死亡率为 1.0%，较低。最常见的病原体是多杀巴斯德菌（61.1%），但也发现了犬巴斯德菌、犬巴斯德菌 dagmatis 和其他巴斯德菌感染。67.7%的标本为混合感染，其他重要病原体为金黄色葡萄球菌、化脓性链球菌、G 组链球菌和铜绿假单胞菌。
巴氏杆菌属仍是重要的临床病原体，具有引起严重和侵袭性感染的能力，导致发病率增加。医院就诊的情况越来越常见，咬伤伤口的多微生物性质对经验性抗生素指南有影响。
