Actinobacillus equuli ssp. haemolyticus in a semi-occlusively treated horse bite wound in a 2-year-old girl.
Abstract: We report on the isolation of Actinobacillus equuli ssp. haemolyticus from wound smears of a 2-year-old girl who was admitted to the hospital due to partial amputation of the distal phalanx of her right middle finger caused by a horse bite. A. equuli typically causes diseases in horses and only very few reports describing human infections (mostly associated with wounds) are available in the literature. Interestingly, although the bacteria could be found in consecutive samples taken at different points in time, there were no signs of advancing infection or inflammation. Moreover, the fingertip regenerated after 74 days under semi-occlusive dressings with very pleasant results. For strain identification two automated systems were employed producing discrepant results: VITEK 2 described the pathogens as Pasteurella pneumotropica while MALDI-TOF MS analysis revealed A. equuli. Sequence analysis of 16S rDNA gene finally confirmed A. equuli ssp. haemolyticus as the isolated strain. The antimicrobial susceptibility testing was performed according to the CLSI criteria for Pasteurella spp. Additionally we conducted a test according to the EUCAST criteria. Wir berichten über den Nachweis von Actinobacillus equuli ssp. haemolyticus aus Wundabstrichen eines 2 Jahre alten Mädchens, welches sich wegen eines Pferdebisses in der Klinik vorstellte. Diese Verletzung führte zu einer teilweisen Amputation der distalen Phalanx ihres rechten Mittelfingers. Bei A. equuli handelt es sich um Bakterien, welche typischerweise Krankheiten bei Pferden verursachen. Bei Menschen findet A. equulii zumeist als Erreger von Wundinfektionen Erwähnung. Die Erreger konnten zu unterschiedlichen Zeitpunkten nachgewiesen werden. Während der gesamten Behandlungsdauer waren keine Zeichen einer fortschreitenden Infektion oder Entzündung zu beobachten. Die Fingerkuppe regenerierte nach 74 Tagen unter semi-occlusiven Verbänden mit einem sehr schönen Ergebnis. Die Erreger wurden mit Hilfe der beiden automatisierten Systeme VITEK 2 und MALDI-TOF MS identifiziert. Die biochemische Untersuchung mittels VITEK 2 identifizierte den Erreger als Pasteurella pneumotropica, wohingegen die massenspektrometrische Analyse A. equuli als Resultat lieferte. Die anschließende Sequenzierung des 16S rDNA Gens erbrachte das Ergebnis A. equuli ssp. haemolyticus und bestätigte somit die Identifikation der MALDI-TOF MS-Analyse. Wir erstellten für den Erreger Antibiogramme nach den Kriterien der amerikanischen Norm (CLSI) für Pasteurella spp. und stellten einen Vergleich zur europäischen Norm (EUCAST) an.
Publication Date: 2013-09-24 PubMed ID: 24068980PubMed Central: PMC3782719DOI: 10.3205/000182Google Scholar: Lookup
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Summary
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This research article presents the case of a 2-year-old girl who, after a horse bite, was found to host the bacterium Actinobacillus equuli ssp. haemolyticus, usually found in horses, in her wound. Despite the infection, the girl’s body showed no signs of progressing infection or inflammation and the fingertip regenerated within 74 days under semi-occlusive dressings. Through the use of two automated systems, VITEK 2 and MALDI-TOF MS, the bacterium was successfully identified.
Actinobacillus equuli Infection in a Human
- This research revolves around a relatively rare disease transmission incident, wherein Actinobacillus equuli ssp. haemolyticus, a bacteria typically found in horses, infects a human. This bacterium was found in the wound of a 2-year-old girl, who had been partially amputated on the distal phalanx of her right middle finger following a horse bite.
- Despite the presence of this bacterium in the wound, there were no observable indications of advancing infection or inflammation in the patient. The patient’s wound even showed signs of regeneration after 74 days of treatment with semi-occlusive dressings.
Identification of the bacterium
- Different techniques were utilized to identify the strain of bacteria found in the patient’s wound. Two automated technologies were employed – VITEK 2 and MALDI-TOF MS, each of which offered contrasting results. The VITEK 2 identified the bacteria as Pasteurella pneumotropica, while MALDI-TOF MS identified it as A. equuli.
- A definitive identification was achieved after the sequencing analysis of 16S rDNA gene, which confirmed the bacterium as A. equuli ssp. haemolyticus.
Antimicrobial susceptibility testing
- Appropriate antibiotic treatment for the identified bacterium was determined through antimicrobial susceptibility testing. This was performed based on the CLSI criteria for Pasteurella spp.
- In addition to the testing performed under CLSI guidelines, the researchers also conducted a test under the EUCAST criteria for comparison.
The study, therefore, presents a unique case of a typically equine bacterium inhabiting a human wound, which unusually did not result in an exacerbated or advancing infection. A. equuli ssp. haemolyticus was judiciously identified via genetic sequencing after discrepancy in identification using two automated systems, and appropriate antibiotic susceptibility testing was carried out to determine the course of treatment.
Cite This Article
APA
Schröttner P, Schultz J, Rudolph W, Gunzer F, Thürmer A, Fitze G, Jacobs E.
(2013).
Actinobacillus equuli ssp. haemolyticus in a semi-occlusively treated horse bite wound in a 2-year-old girl.
Ger Med Sci, 11, Doc14.
https://doi.org/10.3205/000182 Publication
Researcher Affiliations
- Faculty of Medicine, Institute of Medical Microbiology and Hygiene,Universitätsklinikum Carl-Gustav-Carus, Dresden, Germany.
MeSH Terms
- Actinobacillus Infections / diagnosis
- Actinobacillus Infections / microbiology
- Actinobacillus Infections / therapy
- Actinobacillus equuli / isolation & purification
- Animals
- Anti-Bacterial Agents / therapeutic use
- Bandages
- Bites and Stings / diagnosis
- Bites and Stings / microbiology
- Bites and Stings / therapy
- Child, Preschool
- Female
- Horses / microbiology
- Humans
- Treatment Outcome
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Citations
This article has been cited 6 times.- Schultz J, Patel PA, Aires R, Wissing L, Glatte P, Seifert M, Gentzel M, Fitze G, Doyle AM, Sandoval-Guzmán T. Human fingertip regeneration follows clinical phases with distinct proteomic signatures. NPJ Regen Med 2025 Nov 5;10(1):51.
- Vereecke N, Vandekerckhove A, Theuns S, Haesebrouck F, Boyen F. Whole genome sequencing to study antimicrobial resistance and RTX virulence genes in equine Actinobacillus isolates. Vet Res 2023 Apr 5;54(1):33.
- Georgoulis DJ, Melissaridou D, Zafeiris I, Papagelopoulos PJ, Savvidou OD. Nail Regeneration of an Allen III Fingertip Amputation After a Dog Bite Using the Semi-occlusive Dressing Technique: A Case Report and Literature Review. Cureus 2021 Aug;13(8):e17068.
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