Risk factors for invasive pasteurellosis: a retrospective case study

Abstract

Pasteurellosis is a frequent zoonosis mainly transmitted by cats and dogs. Invasive forms of pasteurellosis are associated with significant morbidity and mortality. This retrospective study aimed to highlight risk factors (RFs) for invasive pasteurellosis. We included patients with positive Pasteurella samples. The clinical forms were classified as invasive or local pasteurellosis. We evaluated 13 RFs: age, sex, alcohol use, tobacco use, chronic liver disease, chronic renal failure, diabetes, chronic cardiovascular disease, chronic pulmonary disease, chronic inflammatory disease, chronic osteoarticular disease, immunosuppression, and progressive cancers. One hundred and two patients were enrolled; 28 and 74 had invasive and local forms respectively. Invasive forms included eight isolated bacteraemia, one septic shock, seven large-joint arthritis, two neurological infections, two abdominal infections, and eight pulmonary pasteurellosis. The mortality rate was 4 %, including 11 % and 1.4 % of patients with invasive or localized disease respectively. RFs statistically associated with the invasive group vs the local group were as follows: (1) average age, 63 years (22-93 years) vs 51 years (2-89 years) (p = 0.03), (2) alcohol consumption, 77.8 % vs 25 % (p = 0.03), (3) tobacco use, 64 % vs 25 % (p = 0.006), and (4) chronic liver disease, 21 % vs 1.5 % (p = 0.002). Age was the only significant RF identified using multivariate analysis. Overall, 27 % of patients had an invasive pasteurellosis and experienced significant mortality (11 %). Advanced age, chronic liver disease were the main RFs associated with invasive pasteurellosis. Healthcare providers should be aware of these RFs when patients are exposed to cats or dogs.