Paediatric epidemiology of Pasteurella multocida meningitis in France and review of the literature

Abstract

We report on six cases of Pasteurella multocida (P. multocida) meningitis occurring between 2001 and 2011 by a French nationwide active surveillance network of paediatric bacterial meningitis (ACTIV/GPIP). The cases accounted for 0.15 % of the paediatric meningitis cases reported between 2001 and 2011 in France, all in infants <4 months old. A review of the literature allowed us to gather information on 42 other cases of P. multocida meningitis in infants <1 year old reported since 1963. Among all 48 cases, 44 % were newborns. An animal source of the infection, including 39 household dogs and cats, was suspected or identified in 42 of 48 cases. A traumatic contact between the child and a pet occurred in 8 % of cases, and a vertical transmission from mother to child during birth in 10.4 %. Most of the time, the infection resulted from non-traumatic contact between the child and the pet, through licking or sniffing. The absence of host risk factors suggests that an immature immune system is responsible, given the young age of the children. Although complications, especially neurological lesions, were not rare (37.5 %), the long-term outcome was usually good. Four infants died of meningitis. This rare disease could be prevented by reducing contact between infants and household pets, and by performing simple hygiene measures before handling babies.

Infantile Pasteurella multocida meningitis

“… [12] Traumatic exposure (bites or scratches) is rare with most meningeal infections resulting from salvia exposure via licking or sniffing by a dog or cat. [2] , [11] , [13] Alternatively, exposure may be indirect from being handled by someone who didn’t wash their hands after contact with a pet or via contaminated fomites as in the case of an infant who likely acquired her meningeal infection when the infant used her pacifier after the family cat had licked it. [2] , [11]…”

Occurrence of Pasteurella multocida in Dogs Being Trained for Animal-Assisted Therapy

“…On the other hand, during these interventions, because of repeated contact with the dog’s mucosae (e.g., mouth mucosa), patients can be exposed to zoonotic pathogens (e.g., bacteria, viruses, and fungi) transmitted by the dog through direct contact [ 3 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. Several reports describe human P. multocida infections acquired subsequent to close contact with a dog, such as sharing a bed or by licking or sniffing [ 10 , 16 , 18 ]. P. multocida is part of the normal mouth microbiota of mammals; in dogs, its oropharyngeal colonization rates range from 50% to 66% [ 15 ].…”

“…Although cases of P. multocida infection have been reported more often in people from risk categories, such as young children, the elderly, pregnant women, or immunocompromised individuals [ 22 ], case reports of infection have also been reported in immunocompetent subjects [ 23 , 24 , 25 , 26 ]. In humans, P. multocida can cause serious infections, both invasive and localized, in the oral cavity, respiratory tract, and soft tissue, including pharyngitis, sinusitis, meningitis, tracheobronchitis, pneumonia, empyema, and abscess [ 10 , 18 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ].…”

Neonatal Pasteurella multocida subsp. septica Meningitis Traced to Household Cats: Molecular Linkage Analysis Using Repetitive-Sequence-Based PCR

“…P. multocida is rarely implicated as a cause of meningitis; about 25 cases have been reported in newborns (Յ30 days of age) since 1953. The clinical presentation, laboratory diagnosis, treatment, outcome, and potential risk factors for neonatal P. multocida meningitis are reviewed elsewhere (2,4). In the vast majority of these reported cases, studies linking the organism to an animal source were largely established using phenotypic methods (i.e., serologic typing of capsular or somatic antigens or comparison of antibiogram patterns) that lack sufficient discriminatory power.…”