Pasteurella multocida: Difference between revisions
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===Antimicrobial regimen=== | ===Antimicrobial regimen=== | ||
* ''Pasteurella multocida'' <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref> | * ''Pasteurella multocida'' <ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref> | ||
:* Preferred regimen (1): [[Amoxicillin]] | :* Preferred regimen (1): [[Amoxicillin clavulanate]] 500 mg PO tid or 875 mg PO bid with food | ||
:* Preferred regimen (2): [[Ampicillin]] | :* Note: Its also a preferred empirical coverage of animal bite wounds | ||
:* Preferred regimen (3): [[Ciprofloxacin]] 500 mg PO | :* Preferred regimen (2): [[Ampicillin sulbactam]] 3 g IV q6h | ||
:* Alternative regimen (1): [[Doxycycline]] 100 mg PO | :* Preferred regimen (3): [[Ciprofloxacin]] 500 mg PO bid or 400 mg IV q12h | ||
:* Alternative regimen ( | :* Preferred regimen (4): [[Levofloxacin]] 500 mg PO qd or IV q24h | ||
:* Alternative regimen (1): [[Doxycycline]] 100 mg PO bid {{or}} | |||
:* Alternative regimen (2): [[TMP-SMX]] DS PO bid (for beta-lactam allergic patients ) | |||
:* Alternative regimen (3): [[Penicillin]] 500 mg PO qid or 4 MU IV q4h (use only if isolate known to be susceptible) | |||
==External links== | ==External links== | ||
Revision as of 17:56, 20 July 2015
Pasteurella multocida is a small, Gram-negative, non-motile coccobacillus that is penicillin-sensitive. It can cause a zoonotic infection in humans, which typically is a result of bites or scratches from pets (such as cats and dogs). Many mammals and fowl harbor it as part of their normal respiratory microbiota, displaying asyptomatic infections.
History
Pasteurella multocida was first found in 1878 in fowl cholera-infected birds. However, it was not isolated until 1880, by Louis Pasteur - the man whom Pasteurella is named in honor of.
Disease
P. multocida is the most common cause of infection from animal injuries. (Pneumonia in cattle and pigs, atrophic rhinitt in pigs and goats and wound infections, specially after dog/cat-bites.) A high leukocyte and neutrophil count is typically observed, leading to an inflammatory reaction at the infection site (generally a diffuse localized cellulitis).[1] It can also infect other locales, such as the respiratory tract. In more serious cases, a bacteremia can result, causing an osteomyelitis or endocarditis. The bacteria may also cross the blood-brain barrier and cause a meningitis.[2]
Virulence, Culturing, and Metabolism
A bacteriophage encodes the toxin responsible for most P. multocida virulence factors. This toxin activates Rho GTPases, which bind and hydrolyze GTP, and are important in actin stress fiber formation. Formation of stress fibers may aid in the endocytosis of P. multocida. The host cell cycle is also modulated by the toxin, which can act as an intracellular mitogen.[3]
P. multocida will grow at 37 degrees Celsius on blood or chocolate agar, but will not grow on MacConkey agar. Colony growth is accompanied by a characteristic "mousy" odor due to metabolic products.
Being a facultative anaerobe, it is oxidase- and catalase-positive, and can also ferment a large number carbohydrates in anaerobic conditions.[4]
Treatment
This bacterium is somewhat unusual in that it can be effectively treated with beta-lactam antibiotics, despite its Gram-negative structure. It is also often treated with fluoroquinolones or tetracyclines; fluoroquinolones inhibit bacterial DNA synthesis and tetracyclines interfere with protein synthesis by binding to the bacterial 30S ribosomal subunit.
Antimicrobial regimen
- Pasteurella multocida [5]
- Preferred regimen (1): Amoxicillin clavulanate 500 mg PO tid or 875 mg PO bid with food
- Note: Its also a preferred empirical coverage of animal bite wounds
- Preferred regimen (2): Ampicillin sulbactam 3 g IV q6h
- Preferred regimen (3): Ciprofloxacin 500 mg PO bid or 400 mg IV q12h
- Preferred regimen (4): Levofloxacin 500 mg PO qd or IV q24h
- Alternative regimen (1): Doxycycline 100 mg PO bid OR
- Alternative regimen (2): TMP-SMX DS PO bid (for beta-lactam allergic patients )
- Alternative regimen (3): Penicillin 500 mg PO qid or 4 MU IV q4h (use only if isolate known to be susceptible)
External links
References
- ↑ Ryan KJ; Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed. ed.). McGraw Hill. ISBN 0-8385-8529-9.
- ↑ Casolari C, Fabio U. Isolation of Pasteurella multocida from Human Clinical Specimens: First Report in Italy. European Journal of Epidemiology. Sept 1988; 4(3):389-90
- ↑ [Lacerda HM, Lax AJ, Rozenqurt E. Pasteurella multocida toxin, a potent intracellularly acting mitogen, induces p125FAK and paxillin tyrosine phosphorylation, actin stress fiber formation, and focal contact assembly in Swiss 3T3 cells. J Biol Chem. 5 Jan 1996; 271(1):439-45.
- ↑ Casolari C, Fabio U. Isolation of Pasteurella multocida from Human Clinical Specimens: First Report in Italy. European Journal of Epidemiology. Sept 1988; 4(3):389-90
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.