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BACKGROUND: In October 2014, the Minnesota Department of Health was notified of 5 Hospital A inpatients with Pasteurella multocida bacteremia; 3 died. Human soft tissue infection with P. multocida typically results from cat or dog bites or scratches; invasive infection is rare. We evaluated P. multocida isolations at Hospital A, compared with other Minnesota hospitals, to understand trends in invasive infection.
METHODS: A case was defined as a clinical P. multocida isolate from a Minnesota resident during January 2012–October 2014. All hospital laboratories were queried for P. multocida isolates; Fisher’s Exact Test was used for comparison. Medical charts were reviewed for 2014 Hospital A inpatients with bacteremia.
RESULTS: At Hospital A, compared with other Minnesota Hospitals (response rate 72% [60/83] and outcomes unavailable), the proportion of patients with P. multocida isolated from sterile/total sites was 0% (0/2) versus 11% (19/171) in 2012 (P=1.0), 11% (1/9) versus 12% (23/198) in 2013 (P=1.0), and 83% (5/6) versus 11% (20/189) in 2014 (P<.05). Among 2014 Hospital A bacteremia patients, all 5 were male; median age 70 (range: 44–78) years. Four were temporally clustered within a 5-week period but 3 had bacteremia on admission, making hospital acquisition possible in only 1. Among the 5 bacteremia patients, 4 had cirrhosis and lower extremity ulcerations and 3 died. Three, including only 1 death, reported pet exposures but denied bites or scratches.
CONCLUSIONS: The number of invasive P. multocida cases was significantly higher at Hospital A in 2014. Nonbite exposures (e.g., pets licking wounds) might be an important risk factor for invasive disease among chronically ill persons with ulcerations that could serve as portals of entry.