Pasteurella multocida is a bacterium that is commonly found in various pet species. It typically inhabits the upper respiratory tract of healthy pets, although it is an important cause of respiratory disease in rabbits ("snuffles"). It is also a zoonotic pathogen, and human infections are sporadically reported. Most are associated with bites, mainly from cats. Others have involved pets licking wounds or broken skin. Infections seem to be a particular concern in people undergoing dialysis because of kidney failure. Infections have been associated with things like cats chewing on dialysis tubing and pets having contact with catheter sites.
A recent report described another dialysis-associated infection in person with chronic kidney disease and diabetes (Satomura et al 2010, Ther Apher Dial). The person developed peritoneal dialysis-associated peritonitis. Peritonitis is infection of the internal lining of the abdominal cavity (the space between the intestines/other abdominal organs and the body wall). For peritoneal dialysis, a catheter is left in place which passes through the body wall, and infections can occur from bacteria migrating through or along the catheter and into the peritoneal cavity. In this case, Pasteurella multocida was isolated from the infected peritoneal fluid. The source of infection wasn’t clear, and no obvious risk factors like a cat gnawing on the catheter were reported. However, the same bacterium was isolated from a throat swab taken from the person’s cat. Given how common this bacterium is in cats, how uncommon it is in people, and previous reports of cat-associated infection, it’s logical to assume that the cat was the source.
The fact that no clear risk factors were identified in this case highlights the ever-present (but still relatively low) risk to people with dialysis catheters who have contact with cats. Certain things like keeping the cat away from the catheter site and other dialysis items are common sense and presumably very important. However, general hygiene measures are also probably very important. It is logical that a cat owner could frequently get this bacterium on his or her hands from regular interaction with the cat, or potential from contact with objects like food and water bowls. Good attention to hand hygiene, especially before touching the catheter or any dialysis items, must not be overlooked, and should be an important part of counseling of dialysis patients who own pets. Unfortunately, the risks associated with pets are not always discussed by physicians (who may not even ask about pet ownership), so some people don’t get the required information.
Note: Image is from http://www.kidney.org.uk/kids/crf/page09.html. It’s presumably meant to be a cute image showing a happy (and otherwise healthy) kid undergoing dialysis. It’s interesting that they show a cat in the picture, but no where on the page is there any mention about infection control measures that should be taken around pets. It seems like a missed education opportunity to me.