All about zoonotic infection

1. TULARAEMIA AND BITE
WOUND INFECTION
PRESENTED BY:-KHEMARAM GODARA

2. TULARAEMIA
INTRODUCTION
● Zoonotic infection caused by the bacteria
Francisella tularensis
● Gram-negative aerobe
● Also known as Francis' disease, rabbit fever,
or deer-fly fever

3. ● Human infection is zoonotic and usually results
● Interaction with biting or
blood-sucking insects(especially ticks
and tabanid flies)
● Ingestion of contaminated water or
food
● Inhalation of infective aerosols.

7. PREVALENCE
● E. tularensis has four subspecies:
tularensis, holarctica,novicida, and
mediasiatica.
● The first three subspecies are found in
North America, whereas subspecies
mediasiatica is found in central Asia
● Subspecies tularensis is the most common
and the most virulent among all

8. CLINICAL MANIFESTATION
Tularemia is characterized by various clinical
syndromes:
It is the most common form,accounting for 75-85%
of total cases, characterized by
ulcerative lesion at the
site of inoculation, with regional
● Ulceroglandular tularemia:

9. ● OTHER FORM:-
● COMPLICATION:-
Suppurated lymph nodes, acute-kidney injury,
hepatitis, rhabdomyolysis,pericarditis, meningitis,
osteomyelitis and endocarditis
● AGENT OF BIOTERRORISM
Because of the highly infectious nature, E. tularensis
is currently classified as category A agent of
bioterrorism
include-Pulmonary, oropharyngeal,oculoglandular form
and typhoid-like illness

10. LABORATORY DIAGNOSIS
● CULTURE:- BCG AGAR
Specimen collected by ulcer scraping and lymph
node biopsy
● ANTIBODY DETECTION:-
Agglutination tests (latex and tube agglutination)
and ELISA formats are available
● PCR:-
assay has been used to detect F. tularensis specific
genes encoding the outer-membrane proteins.

11. TREATMENT:-
Gentamicin is considered as the
drug of choice; given for 7-10
days. Doxycycline or
ciprofloxacin can be given as
alternatives.

12. BITE WOUND INFECTION
Bites and scratches from animals and humans allow
the inoculation of microorganisms that are commonly
found in animals oral cavity,nose or nail
● They cause a range of infection
1. Bite wound infections
2. Osteomyelitis and septic arthritis
3. Bacteremia,meningitis,brain abscess and
endocarditis

13. DOG BITES

14. ● Dog bites are responsible for 80% of all animal
bites wounds
AGE:- Children >adults
GENDER:- Males>females
SITES :- Bites most often involve an upper
extremity

15. MICROBIOLOGY :-
The organisms causing dog-bite wound infections are usually mixed
● Common aerobes include beta -hemolytic
streptococci,Pasteurella species and
Staphylococcus
● Many wounds also include anaerobic bacteria
such as Actinomyces, Fusobacterium,
Prevotella, and Porphyromonas species
● Organisms causing systemic diseases: Rabies
and Tetanus

16. CAT BITES

17. ● Cat bites and scratches though less common, than
dog bites.
● Compared to dog bite, they are also at a higher risk of
causing penetrating injury leading septic arthritis and
osteomyelitis (especially in the hand); owing to their
narrow, sharp canine teeth
● Victims of cat bite are more often women than men

18. MICROBIOLOGY :-
The organism implicated in cat-bite wound infections
is usually mixed, from cat's oropharynx; similar to
that of dog bite
● Pasteurella multocida
● Bartonella henselae: Causes cat-scratch disease
● Tularemia (Francisella tularensis)
● S. aureus
● Anaerobes
● Organisms causing systemic disease such as
rabies(rare) and tetanus.

19. HUMAN BITES

20. ● Human bites may take place during fights, domestic
abuse,sexual activity or healthcare workers caring for
patients.
● Human-bite wounds become infected less
frequently(10-15% of the time) than the bites inflicted by
animals
TYPES OF HUMAN BITES
1.Occlusional injuries :during actual bites
2.Clenched-fist injuries: Occurs during
fight,when the fist of one individual
strikes the teeth of another.
● 2nd is more common

21. MICROBIOLOGY :-
● These infections reflect the diverse oral microbial flora of
humans
● Common aerobic isolates include viridans streptococci, S.
aureus, Eikenella corrodens (common in clenched-fist injury),
and Haemophilus influenzae
● Anaerobic species,including Fusobacterium nucleatum and
Prevotella, Porphyromonas, and Peptostreptococcus species
● The oral flora of hospitalized patients often includes
Enterobacteriaceae, non-fermenters in addition to the usual
organism

22. OTHER ANIMAL BITES :-
● They are usually caused by Streptobacillus moniliformis
(rat-bite fever), Leptospira,pasteurella multocida
may become infected with Pseudomonas,Proteus,
Bacteroides fragilis, Clostridium
SNAKE BITES:-
BITES FROM OLD WORLD MONKEY :-
may result in the transmission of B virus (Herpesvirus simiae),
which is a cause of serious infection of the human central
nervous
RAT BITES INFECTION :-

23. SNAKE BITE RAT BITES

24. Laboratory Diagnosis for Bite Wound Infections :-
● The best material for culture is purulent exudate aspirated
from the depth of the wound or samples obtained during
surgery involving incision and drainage or debridement
(removal of all dead and necrotic tissue)
● The most common specimen is a wound swab, which is not
suitable for anaerobic culture, unless immediately dipped
into an anaerobic transport media
● Gram-stained smears should be prepared and examined
● For aerobic cultures, a minimum of blood, MacConkey and
chocolate agar should be inoculated

25. Agents causing Bite-wound Infections
PASTEURELLOSIS :-
Pasteurella multocida is the most common species infecting
man
CLINICAL FEATURES :-
● The affected area of bite becomes red, swollen and
painful with regional lymphadenopathy and low grade
fever
● In more serious cases, bacteremia can result,
causing an osteomyelitis or endocarditis or
meningitis.

26. LABORATORY DIAGNOSIS
● P. multocida is a gram-negative coccobacillus that
readily grows in culture media.
● Identification is made biochemically or through
automated methods such as MALDI-TOF or
VITEK
TREATMENT
● Penicillin G or amoxicillin-clavulanate is
considered as the drug of choice.

27. Capnocytophaga Infection
● They occasionally cause periodontal diseases, and
sepsis/ meningitis in immunocompromised hosts
● Certain species such as C. canimorsus and C.
Cynodesmus are commensals in mouth of dogs and C.
canimorsus can cause fulminant septicemia following
dog bite (in splenic patient)
ASSOCIATED RISK FACTORS
● Include patients with anatomic or functional
asplenia, heavy alcohol intake, or liver Cirrhosis

28. LABORATORY DIAGNOSIS
● They are capnophilic (require CO,), grow in enriched
media (e.g. blood agar), and produce orange-pigmented
colonies. They grow slowly, take up to 14 days
● Identification from the colonies is made
biochemically or through automated methods such
as MALDI-TOF or VITEK.
TREATMENT
● As they produce Beta-lactamases, Beta-
lactam/ß-lactam inhibitor combination such as
ampicillin-sulbactam is used as the drug of choice.

29. RAT BITE FEVER
Rat-bite fever (RBF) is characterized by septic
fever,petechial rashes, and painful polyarthritis with
frequent relapses. It is caused by either of the two
pathogens:
(1) Streptobacillus moniliformis, and (2) Spirillum
minus
● Streptobacillus moniliformis:-Cause RBF in North America
● SPIRILLUM MINUS:- Cause RBF in asia

30. TRANSMISSION:-
● RBF is primarily transmitted by contact with rodents
carrying these bacteria
● Transmission also occurs through consumption of
food or water contaminated with the urine and
droppings of rodents carrying the bacteria. This is
known as Haverhill fever or epidemic arthritic
erythema.
TREATMENT :-
Penicillin is the treatment of choice.

31. THANK YOU