Bacteremia due to Pasteurella spp.:: a rare process in our hospital over the last 8 years

OBJECTIVES. To review and update the epidemic and clinical knowledge concerning disseminated blood disease caused by Pasteurella species in our area. METHODS. Retrospective study of Pasteurella species bacteremia (PSB) episodes occurring in patients attended from January 1994 to December 2001 in a single tertiary hospital. RESULTS. Among the 31 clinical samples remitted to the Microbiology Laboratory in which a species of Pasteurella was identified, 5 (16%) corresponded to positive blood cultures in 5 patients. Pasteurella multocida was the predominant species, identified in 70% of all isolations and all but one positive blood culture. All the patients were adults over 50 years old and all had underlying illnesses causing comorbidity or some degree of immunocompromise, with cardiovascular and hypertensive conditions being the most frequent; only one patient had liver cirrhosis. In all cases, except one, contact or coexistence with dogs or cats was documented. The clinical presentation of PSB was non-specific and only two episodes were related with a possible focal, soft-tissue origin. There were no serious complications, such as septic shock, organ failure or invasive disease (meningitis or endocarditis). All patients cured with antimicrobial treatment, although surgical debridement of infected bite wounds was required in two cases. The betalactams and other families of antibiotics showed excellent in vitro activity against the five strains of Pasteurella isolated. CONCLUSIONS. PSB occurred in adult patients having a wide range of underlying illnesses and comorbidity factors. Most of them had contact with pets, though traumatic lesions were not present in all cases. Clinical presentation did not differ from other types of severe sepsis. Susceptibility and outcome of primary treatment with penicillins and other betalactams shows that they are still appropriate therapy. More emphasis should be placed on preventive measures related to care and hygiene among individuals with pets.