Unusual clinical course
Cory Hussain, Matthew K. Ball, Bradford S. McGwire
Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
Am J Case Rep 2019; 20:268-273
The overuse of antibiotics in animals promotes the development of multidrug-resistance predisposing for severe polymicrobial human infections.
CASE REPORT: We describe a case of spontaneous clostridial myonecrosis due to ulcerative colonic infection with multidrug-resistant Salmonella enterica subsp. enterica, serotype 4,,12: i: –. Serotyping of the colonic Salmonella isolate in the index case and the bovine farm outbreak isolates from where the patient worked indicated they were both serotype I 4,,12: i: –, which is linked with a multitude of large reported disease outbreaks. Further analysis revealed that they are highly genetically related and antibiotic susceptibility testing indicated that they are phenotypically identical.
CONCLUSIONS: Enteritis due to human acquisition of multidrug-resistant Salmonella from cattle led to the invasion and dissemination of Clostridium septicum resulting in devastating myonecrotic disease. This highlights the ramifications of co-existence and evolution of pathogenic bacteria in animals and humans and lends support to reducing the use of antibiotics in animals.
Keywords: Clostridium septicum, multi-drug resistance, Salmonella Infections, Zoonoses