背景致毒棒杆菌是全球范围内一种新兴的人畜共患病,引起皮肤和呼吸道白喉样疾病。在昆士兰,人类感染产毒C.溃疡是罕见的,2015年10月之前仅报告了3例病例。此病例系列描述了昆士兰州随后发生的五例产毒C.ulcerans病例,与伴侣动物有关。方法收集所有数据作为常规公共卫生应对措施的一部分,和菌株的全基因组测序进一步表征。对家庭接触者进行了筛查,用适当的抗生素治疗,并接受了含有白喉类毒素的疫苗,如果他们的最后一次剂量已经过去了五年以上。研究结果在五名患者中的任何一个之间都没有建立流行病学或基因组联系,包括在八天内从同一地方通知的两个案件之间。病例2的溃疡梭菌菌株,4和5与通过全基因组测序从其各自的宠物中分离的菌株密切相关。家犬被确定为病例一和病例三最可能的传播方式;然而,这无法得到实验室的证实,因为病例一的狗在进行测试之前接受了抗生素治疗,案件三号的狗在案件通知前被安乐死并火化。解释这是澳大利亚首次报道的这种与伴侣动物有关的新兴人畜共患病病例。这些病例证明了伴侣动物和人类之间可能的传播途径,没有人传人的证据.昆士兰州卫生公共卫生管理指南中的现有要求,在等待拭子结果时对病例和一些接触的限制,目前正在审查中。
Toxigenic Corynebacterium ulcerans is an emerging zoonosis globally, causing both cutaneous and respiratory diphtheria-like illness. In Queensland, human infection with toxigenic C. ulcerans is rare, with only three cases reported before October 2015. This case series describes five subsequent cases of toxigenic C. ulcerans in Queensland with links to companion animals.
All data were collected as part of routine public health response, and strains were whole genome sequenced for further characterisation. Household contacts were screened, treated with appropriate antibiotics, and received a diphtheria toxoid-containing vaccine if more than five years had elapsed since their last dose.
No epidemiological or genomic links could be established between any of the five patients, including between the two cases notified from the same locality within eight days of each other. The C. ulcerans strains from Cases Two, Four and Five were closely related to the strains isolated from their respective pets by whole genome sequencing. Domestic dogs were identified as the most likely mode of transmission for Cases One and Three; however, this was unable to be laboratory confirmed, since Case One\'s dog was treated with antibiotics before it could be tested, and Case Three\'s dog was euthanised and cremated prior to case notification.
These are the first reported Australian cases of this emerging zoonosis with links to companion animals. These cases demonstrate the likely transmission route between companion animals and humans, with no evidence of human-to-human transmission. The existing requirement in the Queensland Health Public Health Management Guidelines, of restrictions on cases and some contacts while awaiting swab results, is currently under review.