Bacteriologic Analysis of Infected Dog and Cat Bites
David A. Talan, M.D., Diane M. Citron, B.S., Fredrick M. Abrahamian, D.O., Gregory J. Moran, M.D., Ellie J.C. Goldstein, M.D., for The Emergency Medicine Animal Bite Infection Study Group
Background and Methods To define better the bacteria responsiblefor infections of dog and cat bites, we conducted a prospectivestudy at 18 emergency departments. To be eligible for enrollment,patients had to meet one of three major criteria for infectionof a bite wound (fever, abscess, and lymphangitis) or four offive minor criteria (wound-associated erythema, tenderness atthe wound site, swelling at the site, purulent drainage, andleukocytosis). Wound specimens were cultured for aerobic andanaerobic bacteria at a research microbiology laboratory and,in some cases, at local hospital laboratories.
Results The infected wounds of 50 patients with dog bites and57 patients with cat bites yielded a median of 5 bacterial isolatesper culture (range, 0 to 16) at the reference laboratory. Significantlymore isolates grew at the reference laboratory than at the locallaboratories (median, 1; range, 0 to 5; P<0.001). Aerobesand anaerobes were isolated from 56 percent of the wounds, aerobesalone from 36 percent, and anaerobes alone from 1 percent; 7percent of cultures had no growth. Pasteurella species werethe most frequent isolates from both dog bites (50 percent)and cat bites (75 percent). Pasteurella canis was the most commonisolate of dog bites, and Past. multocida subspecies multocidaand septica were the most common isolates of cat bites. Othercommon aerobes included streptococci, staphylococci, moraxella,and neisseria. Common anaerobes included fusobacterium, bacteroides,porphyromonas, and prevotella. Isolates not previously identifiedas human pathogens included Reimerella anatipestifer from twocat bites and Bacteroides tectum,Prevotella heparinolytica,and several porphyromonas species from dog and cat bites. Erysipelothrixrhusiopathiae was isolated from two cat bites. Patients weremost often treated with a combination of a ß-lactamantibiotic and a ß-lactamase inhibitor, which, onthe basis of the microbiologic findings, was appropriate therapy.
Conclusions Infected dog and cat bites have a complex microbiologicmix that usually includes pasteurella species but may also includemany other organisms not routinely identified by clinical microbiologylaboratories and not previously recognized as bite-wound pathogens.
Source Information
From the Divisions of Emergency Medicine and Infectious Diseases, Department of Medicine, Olive View–UCLA Medical Center and UCLA School of Medicine, Los Angeles (D.A.T., G.J.M.); R.M. Alden Research Laboratory, Santa Monica–UCLA Medical Center and UCLA School of Medicine, Los Angeles (D.M.C., E.J.C.G.); and the Department of Emergency Medicine, Maricopa Integrated Health Systems, and the University of Arizona College of Medicine, Tucson (F.M.A.). Presented at the 38th Interscience Conference on Antimicrobial Agents and Chemotherapy, San Diego, Calif., September 25, 1998.
Address reprint requests to Dr. Talan at Olive View–UCLA Medical Center, 14445 Olive View Dr. — North Annex, Sylmar, CA 91342, or at idnet{at}ucla.edu.
Infected Dog and Cat Bites
Jones N., Khoosal M., Numazaki K., Chiba S., Ueno H., Fleisher G. R.
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N Engl J Med 1999;
340:1841-1842, Jun 10, 1999.
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