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[Respiratory pasteurellosis. Description of a first series in Spain]
Objective:
To know the clinical and microbiological characteristics of a first series of 8 patients in whom Pasteurella multocida was detected in samples from low respiratory airways.
Patients And Methods:
Patients with respiratory disease who had positive cultures for P. multocida in several biologic samples between 1986 and 1998 were studied. Patient's data were obtained from clinical files; microbiological study included microscopic examination, qualitative culture in all samples and quantitative culture in low respiratory airway samples.
Results:
P. multocida was detected in 7 males and one female, with a mean age of 63 years (range: 6-71). All but one had a previous bronchial disease: 5 had chronic obstructive bronchial disease, 2 had bronchiectasis and one had relapsing acute bronchitis. Three patients referred a previous contact with pets. The main diagnosis, at the time P. multocida was detected, was exacerbated bronchitis in 4 patients, pneumonia in 2 (one with sepsis and positive blood culture to P. multocida) and another one with empyema. In the only paediatric patient P. multocida was a casual finding. Two patients died, both having a severe immunosuppression. The percentage of P. multocida detection compared to all low respiratory airway isolates along the study period was 0.02%. All samples were purulent and more than 10(7) P. multocida colony-forming units/millilitre were detected. All strains were penicillin-sensitive.
Conclusions:
Pasteurella multocida respiratory infection is rare, although it is probably underestimated owing to the fact that it is difficult to identify when coexisting with oropharingeal flora. Characteristically, in affects old males with bronchial disease are involved and can be life threatening in severely immunosuppressed patients.
Insights
Pasteurella multocida lower respiratory tract infections are rare, typically affecting older males with chronic lung disease. These infections can be severe and life-threatening in immunocompromised individuals.
Area of Science:
- Medical Microbiology
- Pulmonology
- Infectious Diseases
Context:
- Pasteurella multocida is an opportunistic pathogen.
- Lower respiratory tract infections (LRTIs) are common, but P. multocida is an uncommon cause.
- Previous bronchial disease is a significant risk factor.
Purpose:
- To characterize the clinical and microbiological features of P. multocida LRTIs.
- To report the first series of patients with P. multocida detected in lower respiratory tract samples.
Summary:
- This study analyzed 8 patients with P. multocida detected in lower respiratory tract samples.
- The majority were elderly males with pre-existing chronic obstructive bronchial disease or bronchiectasis.
- P. multocida LRTIs were associated with exacerbated bronchitis, pneumonia, sepsis, and empyema, with a mortality rate of 25% in severely immunocompromised patients.
Impact:
- Highlights the rarity and diagnostic challenges of P. multocida LRTIs.
- Emphasizes the association with underlying lung disease and immunocompromise.
- Suggests P. multocida may be an underrecognized cause of bacterial pneumonia and sepsis.