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Pasteurella caballi Infection Following a Horse Bite
Zbl. Bakt. 285,440-444 (1997) © Gustav Fischer Verlag, Jena
Pasteurella caballi Infection Following a Horse Bite FRAN<;OISE ESCANDEl*, ERIC VALLEE 2, and FRAN<;OIS AUBART2 Laboratoire des Pasteurella, CIP, Institut Pasteur, 25 rue du Docteur Roux, Paris Cedex 15, France 2 Centre Hospitalier Emile Roux, Eaubonne, France 1
Received January 15, 1996. Revision received March 22,1996. Accepted May 17, 1996
Summary The isolation of Pasteurella caballj from an horse-bite wound in a 56-year-old man is re ported. Biochemical characteristics are described and compared with the other species re presenting the genus Pasteurella. This strain probably represents the first human isolate of P. caballj in France. Introduction
Pasteurella infections are very important, and in humans, there are several types of disease. Wound infections, most often resulting from animal bites or scratches and sometimes licking are mainly caused by dogs and cats, exceptionally also by other an imals (6, 7, 8). Among the family Pasteurellaceae (14,18) including the genera Actino bacillus, Pasteurella and Haemophilus, these infections are assumed to be caused main ly by P. multocida, but also by P. canis, P. dagmatis and P. stomatis (6, 7, 15). Other species of the family Pasteurellaceae, such as P. aerogenes (19), P. pneumotropica (16), P. "SP." group (13), A.lignieresii (1, 5, 17) and A. suis (12) are exceptionally involved in such infections. The name Pasteurella caballi has been recently proposed for a group of bacteria isolated from respiratory and other infections in horses by Schlater et al. in 1989 (21). Then, Bisgaard et al. isolated one strain from an infected wound of a veterinary surgeon in 1991 (4). We report here the first case of a P. caballi wound infection in France due to a horse bite and probably the second case of infection in man in the world.
* Corresponding author.
Horse Bite Pasteurella Infection
441
Case report A 56-year-old man was admitted to the emergency department of Eaubonne hospi tal (France) a few hours after a horse bite on the left hand. On examination, an impor tant wound on the palmar surface of his forefinger was noted, without bone or joint le sion. This wound was cleaned under anesthesia with Betadine(TM) (polyvinylpolypyr rolidone-iodine) and closed with skin sutures. No swab was taken. The patient was treated with penicillin G (3 g a day) and metronidazole (0.5 g three times a day) given intravenously for 2 days and then orally (1.8 g and 1.5 g daily, respectively) for 5 days. On examination 4 days later, there was a necrosis on the affected finger which was incised 9 days after the horse bite; the antibiotic treatment was changed to oxacillin (1 g three times a day) for 7 days. Five weeks later, the patient returned to the hospital for a re-exploration of the wound: necrosis of the flexor tendons and inflammation of the synovial membrane was found; two sutures were removed and one hematoma was drained from the wound. A new surgical procedure (arthrolysis and tenolysis) was necessary. The same antibiotic treatment (oxacillin) was given for 5 days. Six weeks after the injury, a purulent dis charge was observed from the necrosis of the forefinger and swabs were taken for mi croscopy and culture. The antibiotic treatment was changed to tetracycline (0.1 g three times a day) and ciprofloxacin (0.5 g two times a day) for 6 weeks given orally, then tetracycline for fifteen days after the microbiological examination including sensitivity testing. Ten weeks after the horse bite, the patient recovered completely. Pus from the infected wound was cultured on TSA agar and horse blood (5% voU vol) agar under aerobic conditions and incubated at 3rc for 24 and 48 h. Conven tional and biochemical characteristics were determined as described previously (2). The susceptibility to antibiotics and to the vibrio static compound (0/129) was deter mined by the disk diffusion method on Mueller-Hinton agar supplemented with 0.1 % yeast extract (Difco). The isolate was a non-motile, non-haemolytic, small Gram-negative rod, facultative ly anaerobic which produced gas from glucose, acid from the fermentation of carbo hydrates and gave positive reactions for nitrate and nitrite reduction, ONPG, ornithine decarboxylase and in the porphyrin test. The strain was negative for catalase, indole, urease, arginine dihydrolase, lysine decarboxylase, phenylalanine deaminase and ge latinase. Examination for p-lactamase production was negative. Additional character istics are given in Table 1. The strain was susceptible to amoxicillin plus clavulanate, cephalosporins, chloram phenicol, tetracyclines, aminoglycosides and quinolones, moderately susceptible to penicillin G and erythromycin, but resistant to oxacillin, pristinamycin and sulfona mides. Discussion Our strain presented the same phenotypical characters as the strain described by Bis gaard et al. (4) and the type strain (ATCC 49197T) of the species (21). Table 1 shows the phenotypic characteristics that might differentiate Pasteurella species isolated from human. All species (except P. caballi and sometimes P. bettyae) produce catalase. Among gas producing Pasteurella (P. bettyae, P. caballi, P. aerogenes and P. SP group), P. caballi might be differentiated by 4 characteristics: urease, indole, ONPG and orni-
++++
Catalase Urease Indole Ornithine decarboxylase ONPG N0 2 reduction y-GP VF agar-gasb D-glucose gas L-arabinose Dulcitol D-galactose Inositol Lactose Maltose D-mannitol D-mannose D-raffinose L-rhamnose Sucrose D-sorbitol Trehalose D-xylose
d** +
P. canis
++++
*
+ +
+* *
++++
+++ (+) ++ +
+
+
+ +
+*
++++ **
*
+*
+* +*
*
++ ++
++ ++
+
P. pneuP. caballi motropica
+
d
d/(+) (+)
d
P. bettyae
+
-/(+)
+
+
P. stomatis P. dagmatis
+
*
*
d + ++
dd
+
+*
++ +
P. aerogenes
++ ?
++
+ +
P. species B
+
+ +
*
(+) +
+ + + +*
+ +
+
P. SP group
+: positive; -: negative; (+): weak reaction; d: positive or negative; *: most strains positive or negative; **: different in subspecies or biotypes; a: y-glutamyltransferase; b: "gelose viande-foie", Institut Pasteur Production.
+++ d** ddd d
+ ++++
*
d d** ++++
*
+* +
P. multocida
Characters tested
Table 1. Variable phenotypic characteristics of Pasteurella species isolated from humans
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Horse Bite Pasteurella Infection
443
thine decarboxylase. Furthermore, P. caballi can be easily distinguished from Actino bacillus isolated in humans by its negative reactions of hydrolysis of urea and produc tion of an ornithine decarboxylase. Many organisms (including aerobic, facultative and anaerobic bacteria) are present in the normal oral flora of many domestic animals and may be isolated from wound infections such as bites or scratches. P. caballi has been isolated from various sources in horses (respiratory infection, pneumonia, peritonitis, abscess and genital infection ). Like other species or taxa of Actinobacillus belonging to the family Pasteurellaceae found in the respiratory tract and oral cavity of horses (3, 9,10,11,20), P. caballi may be a commensal bacterium of the oropharyngeal flora of horses. In this case, many antibiotics were initially used to treat the patient and a culture was only taken six weeks after the injury. He received a therapy with penicillin G and metronidazole followed by oxacillin (a drug not appropriate in Pasteurella infections) for a period of three weeks and therapy with tetracyclines/quinolones when the cul ture and sensitivity results were available. It is really important that in serious infec tions, swabs and susceptibility testing of the isolate must be rapidly performed; in this case, the strain was moderately resistant to penicillin G and resistant to oxacillin. Fur thermore, this case highlights the problem of inappropriate treatment; it might not be prudent to use oxacillin empirically in infections associated with animal bites because Pasteurellaceae are resistant. The efficacy of tetracyclines and other ~-lactams (amoxi cillin) has been demonstrated and these antibiotics are the drugs of choice for the treat ment of animal wound infections. The combination of amoxicillin and c1avulanic acid has a broad activity spectrum that covers all of the usual bacteria that may be isolated from wounds resulting from animal contact. To our knowledge, this case represents the second report of Pasteurella caballi in fection in human following a horse bite. Acknowledgements. The author thanks Professor W. Frederiksen (Statens Seruminstitut, Copenhagen, Denmark) for confirmation of the identification.
References
1. Benaoudia, F., F. Escande, and M. Sim onet: Infection due to Actinobacillus lignieresii after a horse bite. Eur. J. Clin. Microbiol. Infect. Dis. 13 (1994) 439-440 2. Bercovier, H., F. Escande, and P. A. D. Crimont: Biological characterization of Actino bacillus species and P. ureae. Ann. Microbiol. (Inst. Pasteur) 135 A, (1984) 203-218 3. Bisgaard, M., K. Piechulla, Y. T. Ying, W. Frederiksen, and W. Mannheim: Prevalence of organisms described as Actinobacillus suis or haemolytic Actinobacillus equuli in the oral cavity of horses. Comparative investigations of strains obtained and porcine strains of A. suis sensu stricto. Acta Path. Microbiol. Immunol. Scand. Sect. B 92 (1984) 291-298 4. Bisgaard, M. , O. Hellberg, and W. Frederiksen: Isolation of Pasteurella caballi from an infected wound on a veterinary surgeon. APMIS (Acta path. microbiol. immunol. scand.) 99 (1991)291-294 5. Dibb, W. L., A. Digranes, and S. Ton;um: Actinobacillus lignieresii infection after a horse bite. Br. Med. J. 283 (1981) 583-584 6. Escande, F. and C. Lion: Epidemiology of human infections by Pasteurella and related groups in France. Zbl. Bakt. 279 (1993) 131-139 7. Escande, F. et C. Lion: Epidemiologie (1985-1992) des infections a Pasteurella et bacteries apparentees. Colloque sur Ie contrale epidemiologique des maladies infectieus es, Med. Mal. Infect. 23 (1993) 520-525 29
Zbl. SakI. 28513
444
F. Escande, E. Vallee, and F. Aubart
w.:
8. Frederiksen, Pasteurellosis of man. In: Pasteurella and pasteurellosis (c. Adlam and J. M. Rutter, eds.), pp.303-320. Academic Press, London - San Diego - New York Berkeley - Boston - Sydney - Tokyo - Toronto (1989) 9. Jang, S. S., E. L. Biberstein, and D. C. Hirsh: Actinobacillus suis-like organisms in hors es. Am. J. Vet. Res. 48 (1987) 1036-1038 10. Kim, B. H., J. E. Phillips, and J. G. Atherton: Actinobacillus suis in the horse. Vet. Rec. 98 (1976)239 11. Larsen, J. L.: Isolation of haemolytic Actinobacilli from horses. Acta Path. Microbiol. Scand. Sect. B 82 (1974) 453-454 12. Lemozy, J., M. Simonet, E. Vallee, and R Escande: Pasteurellaceae inhabituelles isolees apres morsure animale. 4eme Congres de la Societe Franr;:aise de Microbiologie (ab stracts VE-72), Tours (1995) 13. Lion, c., M. C. Conroy, M. L. Dupuy, and R Escande: Pasteurella "SP" group infection after a guinea pig bite. The Lancet, 346 (1995) 901-902 14. Mutters, R., W. Mannheim and M. Bisgaard: Taxonomy of the group. In: Pasteurella and pasteurellosis (c. Adlam and J. M. Rutter, eds.), pp.3-34. Academic Press, Lon don - San Diego - New York - Berkeley - Boston - Sydney - Tokyo - Toronto (1989) 15. Mutters, R., P. Ihm, W. Frederiksen, and W. Mannheim: Reclassification of the Genus Pasteurella Trevisan 1887 on the basis of deoxyribonucleic acid homology, with propo sals for the new species Pasteurella dagmatis, P. canis, P. stomatis, P. anatis, and P. lan gaa. Int. J. System. Bact. 35 (1985) 309-322 16. Olive, c., N. Desbois, R Escande, J. R Colombani, et J. Jouannelle: Infection cutanee a Pasteurella pneumotropica chez un enfant. La Presse Med. 23 (1994) 1226 17. Peel, M. M., K. A. Hornidge, M. Luppino, A. M. Stacpoole, and R. E. Weaver: Actino bacillus spp. and related bacteria in infected wounds of humans bitten by horses and sheep, J. Clin. Microbiol. 29 (1991) 2535-2538 18. Pohl, S.: DNA relatedness among members of Haemophilus, Pasteurella and Actinoba cillus. In: Haemophilus, Pasteurella and Actinobacillus (M. Kilian, W. Frederiksen, and E. L. Biberstein, eds.), pp. 245-253. Academic Press, London - New York - Toronto Sydney - San Francisco (1981) 19. Scheftel, J. M., B. Rhin, M. P. Metzger, P. Frache, D. Marx, H. Montei!, S. Rohr, R Es cande, et R. Minck: Infection d'une plaie par Pasteurella aerogenes chez. un chasseur apres blessure due a une charge de sanglier. Med. Mal. Infect. 5 (1987) 267-268 20. Schlater, L. K. An aerogenic Pasteurella-like organism isolated from horses. J. Vet. Diagn. Invest. 1 (1989) 3-5 21. Schlater, L. K., D.J. Brenner, A. G. Steigerwalt, C. Wayne Moss, M. A. Lambert, and R. A. Packer: Pasteurella caballi, a new species from equine clinical specimens. J. Clin. Microbiol. 27 (1989) 2169-2174
Dr. Fran~oise Escande, Laboratoire des Pasteurella, CIP, Institut Pasteur, 25, rue du Doc teur Roux, F-75724 Paris Cedex 15, France
Pasteurella caballi Infection Following a Horse Bite FRAN<;OISE ESCANDEl*, ERIC VALLEE 2, and FRAN<;OIS AUBART2 Laboratoire des Pasteurella, CIP, Institut Pasteur, 25 rue du Docteur Roux, Paris Cedex 15, France 2 Centre Hospitalier Emile Roux, Eaubonne, France 1
Received January 15, 1996. Revision received March 22,1996. Accepted May 17, 1996
Summary The isolation of Pasteurella caballj from an horse-bite wound in a 56-year-old man is re ported. Biochemical characteristics are described and compared with the other species re presenting the genus Pasteurella. This strain probably represents the first human isolate of P. caballj in France. Introduction
Pasteurella infections are very important, and in humans, there are several types of disease. Wound infections, most often resulting from animal bites or scratches and sometimes licking are mainly caused by dogs and cats, exceptionally also by other an imals (6, 7, 8). Among the family Pasteurellaceae (14,18) including the genera Actino bacillus, Pasteurella and Haemophilus, these infections are assumed to be caused main ly by P. multocida, but also by P. canis, P. dagmatis and P. stomatis (6, 7, 15). Other species of the family Pasteurellaceae, such as P. aerogenes (19), P. pneumotropica (16), P. "SP." group (13), A.lignieresii (1, 5, 17) and A. suis (12) are exceptionally involved in such infections. The name Pasteurella caballi has been recently proposed for a group of bacteria isolated from respiratory and other infections in horses by Schlater et al. in 1989 (21). Then, Bisgaard et al. isolated one strain from an infected wound of a veterinary surgeon in 1991 (4). We report here the first case of a P. caballi wound infection in France due to a horse bite and probably the second case of infection in man in the world.
* Corresponding author.
Horse Bite Pasteurella Infection
441
Case report A 56-year-old man was admitted to the emergency department of Eaubonne hospi tal (France) a few hours after a horse bite on the left hand. On examination, an impor tant wound on the palmar surface of his forefinger was noted, without bone or joint le sion. This wound was cleaned under anesthesia with Betadine(TM) (polyvinylpolypyr rolidone-iodine) and closed with skin sutures. No swab was taken. The patient was treated with penicillin G (3 g a day) and metronidazole (0.5 g three times a day) given intravenously for 2 days and then orally (1.8 g and 1.5 g daily, respectively) for 5 days. On examination 4 days later, there was a necrosis on the affected finger which was incised 9 days after the horse bite; the antibiotic treatment was changed to oxacillin (1 g three times a day) for 7 days. Five weeks later, the patient returned to the hospital for a re-exploration of the wound: necrosis of the flexor tendons and inflammation of the synovial membrane was found; two sutures were removed and one hematoma was drained from the wound. A new surgical procedure (arthrolysis and tenolysis) was necessary. The same antibiotic treatment (oxacillin) was given for 5 days. Six weeks after the injury, a purulent dis charge was observed from the necrosis of the forefinger and swabs were taken for mi croscopy and culture. The antibiotic treatment was changed to tetracycline (0.1 g three times a day) and ciprofloxacin (0.5 g two times a day) for 6 weeks given orally, then tetracycline for fifteen days after the microbiological examination including sensitivity testing. Ten weeks after the horse bite, the patient recovered completely. Pus from the infected wound was cultured on TSA agar and horse blood (5% voU vol) agar under aerobic conditions and incubated at 3rc for 24 and 48 h. Conven tional and biochemical characteristics were determined as described previously (2). The susceptibility to antibiotics and to the vibrio static compound (0/129) was deter mined by the disk diffusion method on Mueller-Hinton agar supplemented with 0.1 % yeast extract (Difco). The isolate was a non-motile, non-haemolytic, small Gram-negative rod, facultative ly anaerobic which produced gas from glucose, acid from the fermentation of carbo hydrates and gave positive reactions for nitrate and nitrite reduction, ONPG, ornithine decarboxylase and in the porphyrin test. The strain was negative for catalase, indole, urease, arginine dihydrolase, lysine decarboxylase, phenylalanine deaminase and ge latinase. Examination for p-lactamase production was negative. Additional character istics are given in Table 1. The strain was susceptible to amoxicillin plus clavulanate, cephalosporins, chloram phenicol, tetracyclines, aminoglycosides and quinolones, moderately susceptible to penicillin G and erythromycin, but resistant to oxacillin, pristinamycin and sulfona mides. Discussion Our strain presented the same phenotypical characters as the strain described by Bis gaard et al. (4) and the type strain (ATCC 49197T) of the species (21). Table 1 shows the phenotypic characteristics that might differentiate Pasteurella species isolated from human. All species (except P. caballi and sometimes P. bettyae) produce catalase. Among gas producing Pasteurella (P. bettyae, P. caballi, P. aerogenes and P. SP group), P. caballi might be differentiated by 4 characteristics: urease, indole, ONPG and orni-
++++
Catalase Urease Indole Ornithine decarboxylase ONPG N0 2 reduction y-GP VF agar-gasb D-glucose gas L-arabinose Dulcitol D-galactose Inositol Lactose Maltose D-mannitol D-mannose D-raffinose L-rhamnose Sucrose D-sorbitol Trehalose D-xylose
d** +
P. canis
++++
*
+ +
+* *
++++
+++ (+) ++ +
+
+
+ +
+*
++++ **
*
+*
+* +*
*
++ ++
++ ++
+
P. pneuP. caballi motropica
+
d
d/(+) (+)
d
P. bettyae
+
-/(+)
+
+
P. stomatis P. dagmatis
+
*
*
d + ++
dd
+
+*
++ +
P. aerogenes
++ ?
++
+ +
P. species B
+
+ +
*
(+) +
+ + + +*
+ +
+
P. SP group
+: positive; -: negative; (+): weak reaction; d: positive or negative; *: most strains positive or negative; **: different in subspecies or biotypes; a: y-glutamyltransferase; b: "gelose viande-foie", Institut Pasteur Production.
+++ d** ddd d
+ ++++
*
d d** ++++
*
+* +
P. multocida
Characters tested
Table 1. Variable phenotypic characteristics of Pasteurella species isolated from humans
~
~
>;
CT P'
> c
~
::l 0.-
P'
~
n>
r;:
£
~
J'
::l 0.-
P'
f) '"
m
tv
.,!:. .,!:.
Horse Bite Pasteurella Infection
443
thine decarboxylase. Furthermore, P. caballi can be easily distinguished from Actino bacillus isolated in humans by its negative reactions of hydrolysis of urea and produc tion of an ornithine decarboxylase. Many organisms (including aerobic, facultative and anaerobic bacteria) are present in the normal oral flora of many domestic animals and may be isolated from wound infections such as bites or scratches. P. caballi has been isolated from various sources in horses (respiratory infection, pneumonia, peritonitis, abscess and genital infection ). Like other species or taxa of Actinobacillus belonging to the family Pasteurellaceae found in the respiratory tract and oral cavity of horses (3, 9,10,11,20), P. caballi may be a commensal bacterium of the oropharyngeal flora of horses. In this case, many antibiotics were initially used to treat the patient and a culture was only taken six weeks after the injury. He received a therapy with penicillin G and metronidazole followed by oxacillin (a drug not appropriate in Pasteurella infections) for a period of three weeks and therapy with tetracyclines/quinolones when the cul ture and sensitivity results were available. It is really important that in serious infec tions, swabs and susceptibility testing of the isolate must be rapidly performed; in this case, the strain was moderately resistant to penicillin G and resistant to oxacillin. Fur thermore, this case highlights the problem of inappropriate treatment; it might not be prudent to use oxacillin empirically in infections associated with animal bites because Pasteurellaceae are resistant. The efficacy of tetracyclines and other ~-lactams (amoxi cillin) has been demonstrated and these antibiotics are the drugs of choice for the treat ment of animal wound infections. The combination of amoxicillin and c1avulanic acid has a broad activity spectrum that covers all of the usual bacteria that may be isolated from wounds resulting from animal contact. To our knowledge, this case represents the second report of Pasteurella caballi in fection in human following a horse bite. Acknowledgements. The author thanks Professor W. Frederiksen (Statens Seruminstitut, Copenhagen, Denmark) for confirmation of the identification.
References
1. Benaoudia, F., F. Escande, and M. Sim onet: Infection due to Actinobacillus lignieresii after a horse bite. Eur. J. Clin. Microbiol. Infect. Dis. 13 (1994) 439-440 2. Bercovier, H., F. Escande, and P. A. D. Crimont: Biological characterization of Actino bacillus species and P. ureae. Ann. Microbiol. (Inst. Pasteur) 135 A, (1984) 203-218 3. Bisgaard, M., K. Piechulla, Y. T. Ying, W. Frederiksen, and W. Mannheim: Prevalence of organisms described as Actinobacillus suis or haemolytic Actinobacillus equuli in the oral cavity of horses. Comparative investigations of strains obtained and porcine strains of A. suis sensu stricto. Acta Path. Microbiol. Immunol. Scand. Sect. B 92 (1984) 291-298 4. Bisgaard, M. , O. Hellberg, and W. Frederiksen: Isolation of Pasteurella caballi from an infected wound on a veterinary surgeon. APMIS (Acta path. microbiol. immunol. scand.) 99 (1991)291-294 5. Dibb, W. L., A. Digranes, and S. Ton;um: Actinobacillus lignieresii infection after a horse bite. Br. Med. J. 283 (1981) 583-584 6. Escande, F. and C. Lion: Epidemiology of human infections by Pasteurella and related groups in France. Zbl. Bakt. 279 (1993) 131-139 7. Escande, F. et C. Lion: Epidemiologie (1985-1992) des infections a Pasteurella et bacteries apparentees. Colloque sur Ie contrale epidemiologique des maladies infectieus es, Med. Mal. Infect. 23 (1993) 520-525 29
Zbl. SakI. 28513
444
F. Escande, E. Vallee, and F. Aubart
w.:
8. Frederiksen, Pasteurellosis of man. In: Pasteurella and pasteurellosis (c. Adlam and J. M. Rutter, eds.), pp.303-320. Academic Press, London - San Diego - New York Berkeley - Boston - Sydney - Tokyo - Toronto (1989) 9. Jang, S. S., E. L. Biberstein, and D. C. Hirsh: Actinobacillus suis-like organisms in hors es. Am. J. Vet. Res. 48 (1987) 1036-1038 10. Kim, B. H., J. E. Phillips, and J. G. Atherton: Actinobacillus suis in the horse. Vet. Rec. 98 (1976)239 11. Larsen, J. L.: Isolation of haemolytic Actinobacilli from horses. Acta Path. Microbiol. Scand. Sect. B 82 (1974) 453-454 12. Lemozy, J., M. Simonet, E. Vallee, and R Escande: Pasteurellaceae inhabituelles isolees apres morsure animale. 4eme Congres de la Societe Franr;:aise de Microbiologie (ab stracts VE-72), Tours (1995) 13. Lion, c., M. C. Conroy, M. L. Dupuy, and R Escande: Pasteurella "SP" group infection after a guinea pig bite. The Lancet, 346 (1995) 901-902 14. Mutters, R., W. Mannheim and M. Bisgaard: Taxonomy of the group. In: Pasteurella and pasteurellosis (c. Adlam and J. M. Rutter, eds.), pp.3-34. Academic Press, Lon don - San Diego - New York - Berkeley - Boston - Sydney - Tokyo - Toronto (1989) 15. Mutters, R., P. Ihm, W. Frederiksen, and W. Mannheim: Reclassification of the Genus Pasteurella Trevisan 1887 on the basis of deoxyribonucleic acid homology, with propo sals for the new species Pasteurella dagmatis, P. canis, P. stomatis, P. anatis, and P. lan gaa. Int. J. System. Bact. 35 (1985) 309-322 16. Olive, c., N. Desbois, R Escande, J. R Colombani, et J. Jouannelle: Infection cutanee a Pasteurella pneumotropica chez un enfant. La Presse Med. 23 (1994) 1226 17. Peel, M. M., K. A. Hornidge, M. Luppino, A. M. Stacpoole, and R. E. Weaver: Actino bacillus spp. and related bacteria in infected wounds of humans bitten by horses and sheep, J. Clin. Microbiol. 29 (1991) 2535-2538 18. Pohl, S.: DNA relatedness among members of Haemophilus, Pasteurella and Actinoba cillus. In: Haemophilus, Pasteurella and Actinobacillus (M. Kilian, W. Frederiksen, and E. L. Biberstein, eds.), pp. 245-253. Academic Press, London - New York - Toronto Sydney - San Francisco (1981) 19. Scheftel, J. M., B. Rhin, M. P. Metzger, P. Frache, D. Marx, H. Montei!, S. Rohr, R Es cande, et R. Minck: Infection d'une plaie par Pasteurella aerogenes chez. un chasseur apres blessure due a une charge de sanglier. Med. Mal. Infect. 5 (1987) 267-268 20. Schlater, L. K. An aerogenic Pasteurella-like organism isolated from horses. J. Vet. Diagn. Invest. 1 (1989) 3-5 21. Schlater, L. K., D.J. Brenner, A. G. Steigerwalt, C. Wayne Moss, M. A. Lambert, and R. A. Packer: Pasteurella caballi, a new species from equine clinical specimens. J. Clin. Microbiol. 27 (1989) 2169-2174
Dr. Fran~oise Escande, Laboratoire des Pasteurella, CIP, Institut Pasteur, 25, rue du Doc teur Roux, F-75724 Paris Cedex 15, France