A case of wound dual infection with Pasteurella dagmatis and Pasteurella Canis resulting from a dog bite - limitations of Vitek-2 system in exact identification of Pasteurella species

European Journal of Medical Research

Y Kawakami⁴  K Oana⁴  M Fujita³  T Kameda³  A Isaka³  N Murayama²  T Matsumoto⁵  M Nagata¹  T Akahane⁶ 

[1] Division of Clinical Microbiology, Department of Clinical Laboratories, Keio University Hospital, Tokyo, Japan;Division of Clinical Microbiology, Department of Clinical Laboratories, Azumino Red Cross Hospital, Azumino, Japan;Division of Clinical Microbiology, Department of Emergency and Critical Care, Azumino Red Cross Hospital, Azumino, Japan;Division of Clinical Microbiology, Department of Biomedical Laboratory Sciences, School of Health Sciences, Shinshu University School of Medicine, Matsumoto, Japan;Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto, Japan;Division of Infection Control and Microbiological Regulation, Department of Health and Medical Sciences, Shinshu University Graduate School of Medicine

关键词: Pasteurella pneumotropica;    Pasteurella canis;    Pasteurella dagmatis;    misidentification;    Vitek 2 system;    dog bite;    dual wound infection;   

Others  :  820376
DOI  :  10.1186/2047-783X-16-12-531

 received in 2011-04-12, accepted in 2011-07-11,  发布年份 2011

【 摘 要 】

Background

Pasteurella species, widely known as indigenous orgganisms in the oral and gastrointestinal floras of many wild and domestic animals, are important pathogens in both animals and humans. Human infections due to Pasteurella species are in most cases associated with infected injuries following animal bites. We encountered a rare case of dual infections caused by different two Pasteurella species occurred in a previously healthy 25-year-old female sustaining injury by a dog-bite.

Methodology

Exudates from the open wound of her dog-bite site, together with the saliva of the dog were submitted for bacteriological examination. Predominantly appearing grayish-white smooth colonies with almost the same colonial properties but slightly different glistening grown on chocolate and sheep blood agar plates were characterized morphologically by Gram's stain, biochemically by automated instrument using Vitek 2 system using GN cards together with commercially available kit system, ID-Test HN-20 rapid panels, and genetically by sequencing the 16S rRNA genes of the organism using a Taq DyeDeoxy Terminator Cycle Sequencing and a model 3100 DNA sequencer instrument.

Results

The causative isolates from the dog-bite site were finally identified as P. canis and P. dagmatis from the findings of the morphological, cultural, and biochemical properties together with the comparative sequences of the 16S rRNA genes. Both the isolates were highly susceptible to many antibiotics and the patient was successfully treated with the administration of so-called the first generation cephalosporin, cefazolin followed by so-called the third generation cephalosporin, cefcapene pivoxil. The isolate from the dog was subsequently identified as P. canis, the same species as the isolate from the patient.

Conclusions

To the best of our knowledge, this was the second report of a dual infection with Pasteurella species consisting of P. dagmatis and P. canis resulting from a dog-bite, followed by the first report of dual infections due to P. dagmatis and P. multocida in 1988. Our isolate finally identified as P. dagmatis was misidentified as P. pneumotripica by means of the Vitek 2 system. The species name "P. dagmatis" was not included in the database of the system. It is also important for routine clinical microbiology laboratories to know the limitation of the automated Vitek 2 system for the accurate identification of Pasteurella species especially P. dagmatis. It should be emphasized that there still exists much room for improvement in Vitek 2 system. Significant improvement of Vitek 2 system especially in the identification of Pasteurella species is urgently desired.

【 授权许可】

   
2011 I. Holzapfel Publishers

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