The public health concern of Pasteurella multocida should not be ignored

Abstract

We read with interest a recent Correspondence1Morsli M Bechah Y Coulibaly O et al.Direct diagnosis of Pasteurella multocida meningitis using next-generation sequencing.Lancet Microbe. 2022; 3: e6Summary Full Text Full Text PDF PubMed Scopus (2) Google Scholar published in The Lancet Microbe, that described the diagnosis of Pasteurella multocida meningitis using next-generation sequencing in a woman aged 77 years. Next-generation sequencing was required as the microorganism is not routinely detected by current point-of-care assays. This publication highlights the public health risk of P multocida in humans. As a well known veterinary pathogen, P multocida is associated with multiple diseases in many animals, and animal pasteurellosis has received a lot of attention due to its substantial economic importance in agriculture.2Wilson BA Ho M Pasteurella multocida: from zoonosis to cellular microbiology.Clin Microbiol Rev. 2013; 26: 631-655Crossref PubMed Scopus (207) Google Scholar However, the public health risk of P multocida has not been given enough attention, apart from the few articles that have been published. As of May 16, 2022, we searched PubMed with the terms “Pasteurella multocida”, “humans”, “patients”, and “pasteurellosis” for reports published, with no language restrictions. Our search identified 330 cases of P multocida infections in humans published between 1975 and 2022, with an average of seven cases per year (appendix). Considering that PubMed only publishes articles written in specific languages and many infections might not be reported, the actual number of human pasteurellosis cases is undoubtedly much higher. This hypothesis could be indirectly supported by the data from a 2019 article, which documented 162 patients with P multocida infection in Szeged, Hungary between 2002 and 2015.3Körmöndi S Terhes G Pál Z et al.Human pasteurellosis health risk for elderly persons living with companion animals.Emerg Infect Dis. 2019; 25: 229-235Crossref PubMed Scopus (7) Google Scholar By analysing the 330 cases published in PubMed, we found that most of these infections are associated with animal exposure, particularly biting, scratching, and even licking by companion animals (mostly cats and dogs). In addition, there are also reports describing the frequent isolation of P multocida strains that are genetically identical to those found in swine from pig farmers and from inhabitants of regions with intensive pig breeding.4Marois C Fablet C Gaillot O Morvan H Madec F Kobisch M Molecular diversity of porcine and human isolates of Pasteurella multocida.J Appl Microbiol. 2009; 107: 1830-1836Crossref PubMed Scopus (11) Google Scholar Therefore, we assessed the capacity of P multocida strains from different host species infecting the human bronchial epithelial cells (BEAS-2B), since P multocida is commonly recognised as a respiratory pathogen.5Peng Z Wang X Zhou R Chen H Wilson BA Wu B Pasteurella multocida: genotypes and genomics.Microbiol Mol Biol Rev. 2019; 83: e00014-e00019Crossref PubMed Scopus (36) Google Scholar We found that P multocida strains from cats, poultry, cattle, and pigs had the capacity to adhere to and invade human BEAS-2B cells (appendix). P multocida is a normal part oral flora of many animals, including dogs, cats, and pigs, and it has been documented with an isolation from 50% for dog bite wounds, 75% for cat bite wounds or scratches, and, less frequently, from licks.2Wilson BA Ho M Pasteurella multocida: from zoonosis to cellular microbiology.Clin Microbiol Rev. 2013; 26: 631-655Crossref PubMed Scopus (207) Google Scholar It is well known that cats and dogs are common companion animals, and pigs are one of the most common meat-producing livestock. With the global economic and social development, the rapid growth of human material and spiritual needs will increase the prevalence of companion animals such as cats and dogs, and food-producing animals such as pigs and cattle. Therefore, P multocida might represent a health risk for humans in the future and the public health concerns for the microorganism should not be ignored. Zhong Peng was financially supported by the National Natural Science Foundation of China (grant number 31902241) and the China Postdoctoral Foundation (grant number 2020T130232). All other authors declare no competing interests. Download .pdf (.51 MB) Help with pdf files Supplementary appendix Direct diagnosis of Pasteurella multocida meningitis using next-generation sequencingWe recently implemented a real-time metagenomic sequencing approach (Oxford Nanopore Technologies, Oxford, UK) for a community-acquired, life-threatening case of meningitis diagnosed in a point-of-care laboratory,1 to complement point-of-care diagnosis by PCR-based multiplex assays.2 Here we describe how real-time metagenomic sequencing enabled the direct diagnosis of meningitis caused by Pasteurella multocida, which is not routinely detected by current point-of-care assays, from cerebrospinal fluid (CSF) collected from a patient. Full-Text PDF Open Access