Pasteurella canis osteomyelitis and cutaneous abscess after a domestic dog bite

Pasteurella canis soft tissue infection after a cat bite - A case report

Pasteurella canis is a Gram-negative facultative anaerobic bacterium that is a typical commensal of the oral cavity and enteric tract of domestic animals. Human infections caused by this species are most often associated with dog bites and rarely with other animal bites. In this report, we present a case of a 34-year-old man who developed P. canis soft tissue infection of the left hand after a cat bite. The patient was successfully treated by a surgical intervention and antibiotics. The species identification of the isolate was performed by a conventional automatic system and nucleic acid-based methods. The nucleic acid-based methods provide a powerful alternative to the conventional microbiological diagnostic of these bacteria.

Evidence Supporting Oral Hygiene Management by Owners through a Genetic Analysis of Dental Plaque Bacteria in Dogs

With the increase in the number of households raising dogs and the reports of human-to-dog transmission of oral bacteria, concerns about dogs' oral health and the need for oral hygiene management are increasing. In this study, the owners' perceptions about their dogs' oral health and the frequency of oral hygiene were determined along with the analysis of dog dental plaque bacteria through metagenomic amplicon sequencing so as to support the need for oral hygiene management for dogs. Although the perception of 63.2% of the owners about their dogs' oral health was consistent with the veterinarian's diagnosis, the owners' oral hygiene practices regarding their dogs were very poor. The calculi index (CI) and gingiva index (GI) were lower in dogs who had their teeth brushed more than once a week (57.89%) than in dogs brushed less than once a month (42.10%); however, the difference was nonsignificant (CI: p = 0.479, GI: p = 0.840). Genomic DNA was extracted from dental plaque bacteria removed during dog teeth scaling, and metagenomic amplicons were sequenced. The 16S amplicons of 73 species were identified from among the plaque bacteria of the dogs. These amplicons were of oral disease-causing bacteria in humans and dogs. The 16S amplicon of Streptococcus mutans matched that of the human S. mutans, with type c identified as the main serotype. This result suggests that human oral bacteria can be transmitted to dogs. Therefore, considering the high frequency of contact between dogs and humans because of communal living and the current poor oral health of dogs, owners must improve the oral hygiene management of their dogs.

Primary subacute talus osteomyelitis caused by Pasteurella canis: literature review and case report

In this review, we would like to demonstrate the case of a 6-year-old girl who presented with progressive ankle pain and eventual inability to weight bear. She was shown to have primary acute osteomyelitis of the talus caused by Pasteurella canis, a commensal organism usually found in the oropharynx of dogs, despite the absence of any history of a dog bite or other zoonotic risk factors. We characterise the symptoms, signs, radiographic appearances and result of both the medical and surgical management, including a review of the literature. This review aims to increase awareness of this rare pathology and help guide other clinicians in accurately diagnosing and managing the condition.

Biotypic and genotypic diversity in Pasteurella canis isolated from host animals and humans: differences in trehalose fermentation and nucleotide sequences encoding trehalose-6-phosphate hydrolase (treC)

The biotypic and genotypic features of Pasteurella canis isolated from dogs, cats, and humans were clarified by repetitive sequence-based fingerprinting and nucleotide sequences encoding trehalose-6-phosphate hydrolase (treC). Thirty P. canis and 48 P. multocida isolates were collected from dogs, cats, and humans to perform biotyping. The genotyping of P. canis by fingerprinting was followed by dendrogram construction. The whole-genome sequences (WGSs) were searched for the enzyme-coding nucleotide sequences around the main and adjacent loci constituting the operon. Full-length nucleotide sequences encoding the enzyme were determined using polymerase chain reaction and direct sequencing. Biotypic results were compared to the dendrogram and nucleotide sequence data. We observed a difference in trehalose fermentation with a positivity rate of 46.7%. Two (A-1/A-2) and three (B-1/B-2/B-3) clades were located on the dendrograms generated based on two repetitive sequence-based fingerprinting techniques, showing no association between trehalose fermentation and the clades. Based on the WGSs, two variants of the gene, namely, a 1,641 bp gene treC and a pseudogene (1,335 bp) of treC with its first 306 nucleotides deleted, were observed. Trehalose-positive isolates harbored treC, whereas trehalose-negative isolates lacked treC with or without the pseudogene. Our observations suggest biotypic and genotypic diversity among the P. canis isolates from animal and human hosts, with respect to trehalose fermentation and treC nucleotide sequences. This is the first report on the diversity of treC nucleotide sequences among these isolates.

Nanopore Sequencing Using the Full-Length 16S rRNA Gene for Detection of Blood-Borne Bacteria in Dogs Reveals a Novel Species of Hemotropic Mycoplasma

Dogs across the globe are afflicted by diverse blood- and vector-borne bacteria (VBB), many of which cause severe disease and can be fatal. Diagnosis of VBB infections can be challenging due to the low concentration of bacteria in the blood, the frequent occurrence of coinfections, and the wide range of known, emerging, and potentially novel VBB species encounterable. Therefore, there is a need for diagnostics that address these challenges by being both sensitive and capable of detecting all VBB simultaneously. We detail the first employment of a nanopore-based sequencing methodology conducted on the Oxford Nanopore Technologies (ONT) MinION device to accurately elucidate the "hemobacteriome" from canine blood through sequencing of the full-length 16S rRNA gene. We detected a diverse range of important canine VBB, including Ehrlichia canis, Anaplasma platys, Mycoplasma haemocanis, Bartonella clarridgeiae, "Candidatus Mycoplasma haematoparvum", a novel species of hemotropic mycoplasma, and Wolbachia endosymbionts of filarial worms, indicative of filariasis. Our nanopore-based protocol was equivalent in sensitivity to both quantitative PCR (qPCR) and Illumina sequencing when benchmarked against these methods, achieving high agreement as defined by the kappa statistics (k > 0.81) for three key VBB. Utilizing the ability of the ONT' MinION device to sequence long read lengths provides an excellent alternative diagnostic method by which the hemobacteriome can be accurately characterized to the species level in a way previously unachievable using short reads. We envision our method to be translatable to multiple contexts, such as the detection of VBB in other vertebrate hosts, including humans, while the small size of the MinION device is highly amenable to field use. IMPORTANCE Blood- and vector-borne bacteria (VBB) can cause severe pathology and even be lethal for dogs in many regions across the globe. Accurate characterization of all the bacterial pathogens infecting a canine host is critical, as coinfections are common and emerging and novel pathogens that may go undetected by traditional diagnostics frequently arise. Deep sequencing using devices from Oxford Nanopore Technologies (ONT) provides a solution, as the long read lengths achievable provide species-level taxonomic identification of pathogens that previous short-read technologies could not accomplish. We developed a protocol using ONT' MinION sequencer to accurately detect and classify a wide spectrum of VBB from canine blood at a sensitivity comparable to that of regularly used diagnostics, such as qPCR. This protocol demonstrates great potential for use in biosurveillance and biosecurity operations for the detection of VBB in a range of vertebrate hosts, while the MinION sequencer's portability allows this method to be used easily in the field.

Septic Arthritis and Bacteremia Due to Infection by Pasteurella canis

Pasteurella canis is a Gram-negative coccobacilli from the Pasteurellaceae family. The most common form of transmission to humans is a bite from a dog or a cat. We report a case of a 90-year-old woman who presented with septic arthritis in the right knee and bacteremia two weeks after a cat bite. The patient was treated with arthrocentesis and directed antimicrobial therapy. Human Pasteurella canis infection is a rare occurrence, making this a case of note.

Oral bacterial DNA-based discrimination of human and canine saliva for the analysis of indistinct bite marks

Analyzing ambiguous bite marks using conventional morphological approaches to identify attackers is difficult; thus, applying molecular biological methods for identifying an attacker from their saliva is a possible approach in a forensic investigation. This study aimed to establish oral bacterial DNA-based human and canine saliva markers and develop a practical method for their discrimination. We considered Streptococcus oralis and Pasteurella canis as human and canine saliva marker candidates, respectively. Duplex bacterial DNA detection using melting curve analysis was designed and evaluated for forensic applicability using proof-of-concept experiments. S. oralis DNA was detected from human saliva samples from 30 out of 30 individuals, and P. canis DNA was detected from canine saliva samples from 73 out of 77 individuals (26 dog breeds). Additionally, both bacterial DNA markers were accurately detected from human blood-contaminated saliva samples and mock indistinct bite marks. Our results indicate that both bacterial DNA markers were sensitive, robust, and discriminating saliva markers. We consider that our duplex bacterial DNA examination is a simple, practical, and useful method for the detection of saliva from indistinct bite marks and discrimination between human and canine saliva.

An Epidemiological Analysis of Pediatric Dog Bite Injuries Over a Decade

BACKGROUND

An estimated 800,000 dog bites require medical attention every year. The purpose of this study is to review the characteristics of dog bite injuries in children and examine temporal trends.

METHODS

The Kids' Inpatient Database was used to identify pediatric patients with dog bite injuries over a 10-y period. Demographic data, primary payer, injury characteristics, length of hospitalization, and treatments were recorded. Statistical analysis was performed in SAS 9.3 (SAS Institute Inc, Cary, NC).

RESULTS

A total of 6308 patients were identified. Average age at time of injury was 6.4 ± 4.3 y. Children under age 5 y were the most affected subgroup (39.3% in 2000 versus 44.7% in 2009, P < 0.001). Most bites were to the head/neck and significantly increased from 53.9% in 2000 to 60.1% in 2009. Cellulitis complicated many injuries (33.7% in 2000 versus 44.8% in 2009, P < 0.001). Overall, 50% of patients underwent a procedure; 31% had an invasive surgical procedure; and 5.1% of patients required skin grafts or flaps.

CONCLUSIONS

Dog bites are a common cause of pediatric injuries and are a significant burden on families and the health care system. Evaluating the characteristics of these injuries can guide educational efforts.

Pasteurella canis infective endocarditis in a dog

Infective endocarditis, an infrequent clinical syndrome in dogs, is typically associated with nondescript clinical signs such as fever, malaise and loss of appetite. Although an uncommonly reported infection in dogs, Pasteurella canis is an emerging pathogen with increasing relevance in the human microbiology literature. The goal of this study is to detail the clinical presentation and microbiological findings associated with a novel causative agent of infective endocarditis in the dog. Diagnostic evaluation as well as conventional, automated and molecular microbiological methods are highlighted. The recent literature regarding P. canis and infective endocarditis in companion animals and humans is reviewed. Although an unusual etiologic agent of infective endocarditis, awareness of P. canis as a diagnostic possibility is crucial to accurate microbial surveillance.

Medical and surgical management of Pasteurella canis infectious keratitis

Introduction

We describe a case of refractory Pasteurella Canis keratitis that initially failed antimicrobial treatment but was successfully treated with a conjunctival flap followed by a penetrating keratoplasty.

Case discussion

A 70-year-old male had persistent corneal edema related to previous herpes zoster keratouveitis with visual acuity of 20/400. An endothelial keratoplasty was performed with improvement in vision to 20/25. Several months after this surgery the patient developed a corneal infiltrate and cultures grew Pasturella canis. The infection persisted despite topical treatment with broad spectrum fortified vancomycin, tobramycin and fluoroquinolones. A conjunctival flap combined with corneal cryotherapy was performed to help mitigate symptoms and to allow the ulcer to heal. A penetrating keratoplasty was done several months later.

Discussion

The patient achieved pain relief immediately after the flap was placed. Medications were tapered off in the following few months after the procedure. A penetrating keratoplasty was performed 4 months later. The patient has remained almost entirely symptom free, and the graft remained clear one year after surgery.

Conclusions

A keratitis caused by Pasteurella canis that is resistant to medical therapy can be treated successfully with a conjunctival flap and cryotherapy followed by a penetrating keratoplasty.

Unusual Aetiology of Pasteurella canis Biovar 2 Causing Dacryocystitis in HIV Patient: A Case Report and Review of Literature

Pasteurella species are zoonotic bacterial pathogens implicated very infrequently in various human infections following animal bites or licks usually of dogs and cats. This case report described a rare clinical presentation of dacryocystitis caused by P.canis in a Human Immunodeficiency Virus (HIV) positive young male patient involved in caring of cattle. It advocates the utmost need of recognizing the wide clinical manifestation spectrum of P.canis even without prior penetrating injury. P.canis associated clinical infection is more extensive than had been thought previously especially in immunocompromised patient. Early accurate identification and evidence based anti-microbial therapy may prove crucial in preventing further potential complications.

Osteomyelitis following Domestic Animal Bites to the Hand: Two Case Reports and Practical Guidelines

Recently, the number of cases of animal bite wounds has increased significantly in concordance with an increase in the pet population around the world. The authors report two rare cases of osteomyelitis of the phalanx following cat and dog bites. On initial physical examination, signs of a severe infection were observed. Radiographs of both patients showed the presence of osteomyelitis, and in one of the patients, the diagnosis was confirmed with a bone biopsy. After use of empirical antibiotics, intravenous antibiotic therapy that matched the identified bacterium's sensitivity was initiated, and at the same time, secure dressing including debridement was performed to induce secondary healing. In addition, the patients were closely monitored with serial X-rays, and culture and blood test follow-up. One patient fully recovered without sequelae, but the other patient suffered a loss of distal interphalangeal joint motion. When dealing with bite wounds located on the hand, it is important to visit the hospital as soon as possible and receive the appropriate treatment early. Moreover, to prevent severe complications such as osteomyelitis, it is important to administer antibiotic therapy to which the cultured bacteria are sensitive, along with proper wound management and prophylactic antibiotic treatment.

A Case of Lower Respiratory Tract Infection with Canine-associated Pasteurella canis in a Patient with Chronic Obstructive Pulmonary Disease

This is the report of lower respiratory tract infection with Pasteurella canis in a chronic obstructive pulmonary disease (COPD) patient with history of casual exposure to cats. Pasteurella species are part of the oral and gastrointestinal flora in the canine animals. These organisms are usually implicated in wound infection following animal bites, but can also be associated with a variety of infections including respiratory tract infections.

Pasteurella canis osteoarticular infections in childhood: review of bone and joint infections due to pasteurella species over 10 years at a tertiary pediatric hospital and in the literature

BACKGROUND

Pasteurella spp. are important bacterial pathogens in both animals and humans. Most reported Pasteurella infections in humans involve skin and soft tissues, often after an animal bite, scratch, or lick to an open wound. Infections involving bone and joints are well recognized, but have not been previously reported due to Pasteurella canis without a history of penetrating dog bite.

METHODS

We report a case of P. canis osteomyelitis in a 14-month-old girl and a case of P. canis septic arthritis in a 19-month-old girl, both occurring without any preceding penetrating injury. Review of all osteoarticular infections due to Pasteurella spp. at our tertiary pediatric hospital over the past 10 years was performed by obtaining the patient records of all children with positive bacterial cultures from any site for Pasteurella spp. as identified through our microbiology laboratory database. A MEDLINE and EMBASE database search was then performed to identify published pediatric cases in the literature since 1950.

RESULTS

In addition to the cases of P. canis osteomyelitis and septic arthritis outlined, we identified 8 children with positive cultures for Pasteurella spp. from the hospital's microbiology database. Two of these children had deep tissue contamination involving bone and/or joints secondary to animal bites. Ten further published cases were identified from the literature since 1950.

CONCLUSIONS

: Established Pasteurella osteomyelitis and septic arthritis secondary to animal bites can be largely prevented through appropriate wound management at the time of injury. However, the potential for deep tissue infection with this organism, including the species P. canis, without prior penetrating injury should be recognized.

LEVEL OF EVIDENCE

Level IV-case series.

Pasteurella canis and Granulicatella adiacens conjunctivitis outbreak resistant to empirical treatment in a child welfare agency

PURPOSE

To investigate pathogens associated with bacterial conjunctivitis resistant to the empirical treatment and their antibiotic resistance in a child welfare agency.

METHODS

Twenty-eight eyes in 14 children with a median age of 3 months with conjunctivitis resistant to the empirical treatment were included in this study. Samples were taken three times from the inferior fornix in both eyes using cotton swabs, cultured onto chocolate and blood agar, and prepared for Gram staining. Antibiograms were evaluated according to the Clinical and Laboratory Standards Institute criteria by disc diffusion method.

RESULTS

The conjunctival culture positivity rate was 35.7% in eyes with conjunctivitis resistant to the empirical treatment. The most common isolated bacteria were Pasteurella canis (25%), penicillin-nonsusceptible Streptococcus pneumoniae (7.1%), and Granulicatella adiacens (3.6%). According to culture results, ophthalmic solutions of vancomycin (50 mg/mL) or gentamicin (30 mg/mL) were applied in eyes with positive conjunctival culture. Previously applied multiple treatments were stopped in eyes with negative conjunctival culture. All eyes improved clinically during follow-up.

CONCLUSION

Because unusual pathogens may cause a conjunctivitis outbreak, physicians should not insist on empirical treatment. Taking conjunctival culture and antibiotic switching according to antibiogram may be helpful.

Pasteurella canis Isolation following Penetrating Eye Injury: A Case Report

A 3-year-old boy presented with history of trauma to the left eye after he accidentally injured his eye with a broom stick made up from coconut skewers. There was history of cats as their pets but not dogs. Ocular examination revealed left superonasal conjunctival laceration and scleral perforation with prolapsed vitreous. Fundus examination showed minimal vitreous haemorrhage and flat retina. Conjunctiva swab at the wound site was sent for gram staining, culture, and sensitivity. He underwent scleral suturing, vitreous tap, and intravitreal injection of Ceftazidime and Amikacin. Vitreous tap was sent for gram stained, culture and sensitivity. Postoperatively, he was started empirically on IV Ciprofloxacin 160 mg BD, Guttae Ciprofloxacin, and Guttae Ceftazidime. Conjunctiva swab grew Pasteurella canis which was sensitive to all Beta lactams, Ciprofloxacin, Chloramphenicol, and Aminoglycoside. Post-operative was uneventful, absent signs of endophthalmitis or orbital cellulitis.

Vertebral osteomyelitis and meningomyelitis caused by Pasteurella canis in a dog--clinicopathological case report

A clinicopathological case study of vertebral osteomyelitis caused by Pasteurella canis in a 2.5-year-old male Jack Russell Terrier is presented. The case was characterised by a chronic course with signs of spinal pain and acute paraplegia. The diagnosis was established by radiography, myelography, post-myelographic CT examination, and laboratory tests including routine blood work and cerebrospinal fluid (CSF) cytology, and confirmed by postmortem pathological and microbiological examinations. Diagnostic imaging showed severe osteolysis, ventral spondylosis and spinal cord compression at the 4th and 5th lumbar vertebrae. The blood tests revealed mild leukocytosis and anaemia, while CSF cytology showed lymphocytic and mononuclear pleocytosis. Necropsy demonstrated severe osteomyelitis and meningomyelitis, but the source of infection could not be established. To the authors' knowledge, this is the first description of canine vertebral osteomyelitis caused by this organism.

Pasteurella abscess in tibial regenerate bone: a case report

Although superficial pin tract infections during limb lengthening are extremely common, most settle spontaneously or with antibiotics. In contrast, deep infection around pin tracts leading to osteomyelitis and abscess formation is much less frequently observed and may need washout and curettage. We report a case of a 10-year-old boy who presented with latent abscess formation at a tibial lengthening site because of Pasteurella, a rare bacterial cause of infection usually associated with animals. To our knowledge, this is the first reported case of abscess formation within regenerate bone associated with this organism and its late presentation in previously well-healed bone is surprising.

Pasteurella multocida infection of a total knee arthroplasty after a "dog lick"

The patient we report here underwent a total knee arthroplasty (TKA) which got infected with P. multocida after her dog had licked a small wound at the third toe of the same foot. Despite a correct treatment comprising synovectomy and cleansing, and an active antibiotic treatment for 3 months, the patient was readmitted for persistent infection of the same knee 2 weeks after the end of the antibiotic treatment. Sampling during surgery allowed for the growth of a P. multocida isolate proven by a molecular method to be identical to the previously isolated strain. This recurrent P. multocida infection was treated by a two-step change of the TKA comprising a 2-month period of antibiotic treatment between the two surgical interventions.

Pasteurella haemolytica in Human Urine

Pasteurella haemolytica was isolated from a human urine specimen. This unusual human pathogen showed a mucoid colony with a modest haemolysis and typical biochemical characteristics. API 20E and API 20NE identified the bacterium as Pasteurella spp. and P. haemolytica, respectively. To the authors' knowledge, this is the first reported case of P. haemolytica in human urine.