Skip to main content
SpringerLink
Log in

Capnocytophaga zoonotic infections: a 10-year retrospective study (the French CANCAN study)

  • Original Article
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Zoonotic species of Capnocytophaga genus belong to the oral microbiota of dogs and cats. They may be responsible for serious human infections, mainly after animal bites, with a high mortality rate. In France, only few cases have been reported and no multicenter study has been conducted. Our aim was to describe the French epidemiology of Capnocytophaga zoonosis. We conducted a multicenter (21 centers) retrospective non-interventional, observational study in France describing the epidemiology of Capnocytophaga zoonosis (C. canimorsus, C. cynodegmi, C. canis) over 10 years with regard to clinical and bacteriological data. From 2009 to 2018, 44 cases of Capnocytophaga zoonotic infections were described (C. canimorsus, n = 41; C. cynodegmi, n = 3). We observed an increase (2.5 times) in the number of cases over the study period (from the first to the last 5 years of the study). The most frequent clinical presentations were sepsis (n = 37), skin and soft tissue infections (n = 12), meningitis (n = 8), osteoarticular infections (n = 6), and endocarditis (n = 2). About one-third of patients with sepsis went into septic shock. Mortality rate was 11%. Mortality and meningitis rates were significantly higher for alcoholic patients (p = 0.044 and p = 0.006, respectively). Other comorbidities included smoking, splenectomy, diabetes mellitus, and immunosuppressive therapy are associated to zoonotic Capnocytophaga infection. Eighty-two percent of cases involved contact with dogs, mostly included bites (63%). Despite all isolates were susceptible to the amoxicillin-clavulanic acid combination, three of them were resistant to amoxicillin.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Code availability

Not applicable.

References

  1. Holt SC. Capnocytophaga. Bergey’s manual of systematics of archaea and bacteria, Wiley, New York, NY; 2015, p. 1–13. https://doi.org/10.1002/9781118960608.gbm00299.

  2. Brenner DJ, Hollis DG, Fanning GR, Weaver RE. Capnocytophaga canimorsus sp. nov. (formerly CDC group DF-2), a cause of septicemia following dog bite, and C. cynodegmi sp. nov., a cause of localized wound infection following dog bite. J Clin Microbiol 1989;27:231–5.

  3. Renzi F, Dol M, Raymackers A, Manfredi P, Cornelis GR. Only a subset of C. canimorsus strains is dangerous for humans. Emerg Microbes Infect 2015;4:e48. https://doi.org/10.1038/emi.2015.48.

  4. Zangenah S, Abbasi N, Andersson AF, Bergman P (2016) Whole genome sequencing identifies a novel species of the genus Capnocytophaga isolated from dog and cat bite wounds in humans. Sci Rep 6:22919. https://doi.org/10.1038/srep22919

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Suzuki M, Umeda K, Kimura M, Imaoka K, Morikawa S, Maeda K. Capnocytophaga felis sp. nov. isolated from the feline oral cavity. Int J Syst Evol Microbiol 2020;70:3355–60. https://doi.org/10.1099/ijsem.0.004176.

  6. Butler T (2015) Capnocytophaga canimorsus: an emerging cause of sepsis, meningitis, and post-splenectomy infection after dog bites. Eur J Clin Microbiol Infect Dis 34:1271–1280. https://doi.org/10.1007/s10096-015-2360-7

    Article  CAS  PubMed  Google Scholar 

  7. Lion C, Escande F, Burdin JC (1996) Capnocytophaga canimorsus infections in human: review of the literature and cases report. Eur J Epidemiol 12:521–533. https://doi.org/10.1007/bf00144007

    Article  CAS  PubMed  Google Scholar 

  8. Zangenah S, Ozenci V, Boräng S, Bergman P. Identification of blood and wound isolates of C. canimorsus and C. cynodegmi using VITEK2 and MALDI-TOF. Eur J Clin Microbiol Infect Dis 2012;31:2631–7. https://doi.org/10.1007/s10096-012-1606-x.

  9. Pers C, Gahrn-Hansen B, Frederiksen W (1996) Capnocytophaga canimorsus septicemia in Denmark, 1982–1995: review of 39 cases. Clin Infect Dis 23:71–75. https://doi.org/10.1093/clinids/23.1.71

    Article  CAS  PubMed  Google Scholar 

  10. van Dam AP, Jansz A (2011) Capnocytophaga canimorsus infections in the Netherlands: a nationwide survey. Clin Microbiol Infect 17:312–315. https://doi.org/10.1111/j.1469-0691.2010.03195.x

    Article  PubMed  Google Scholar 

  11. Janda JM, Graves MH, Lindquist D, Probert WS (2006) Diagnosing Capnocytophaga canimorsus infections. Emerg Infect Dis 12:340–342. https://doi.org/10.3201/eid1202.050783

    Article  PubMed  PubMed Central  Google Scholar 

  12. Suzuki M, Kimura M, Imaoka K, Yamada A (2010) Prevalence of Capnocytophaga canimorsus and Capnocytophaga cynodegmi in dogs and cats determined by using a newly established species-specific PCR. Vet Microbiol 144:172–176. https://doi.org/10.1016/j.vetmic.2010.01.001

    Article  CAS  PubMed  Google Scholar 

  13. Umeda K, Hatakeyama R, Abe T, Takakura K-I, Wada T, Ogasawara J et al (2014) Distribution of Capnocytophaga canimorsus in dogs and cats with genetic characterization of isolates. Vet Microbiol 171:153–159. https://doi.org/10.1016/j.vetmic.2014.03.023

    Article  PubMed  Google Scholar 

  14. van Dam AP, van Weert A, Harmanus C, Hovius KE, Claas ECJ, Reubsaet FAG. Molecular characterization of Capnocytophaga canimorsus and other canine Capnocytophaga spp. and assessment by PCR of their frequencies in dogs. J Clin Microbiol 2009;47:3218–25. https://doi.org/10.1128/JCM.01246-09.

  15. Plaies aigues en structure d’urgences-Référentiel des bonnes pratiques SFMU/SPILF 2017. https://www.infectiologie.com/UserFiles/File/spilf/recos/2017-rbp-plaies.pdf n.d.

  16. Hästbacka J, Hynninen M, Kolho E (2016) Capnocytophaga canimorsus bacteremia: clinical features and outcomes from a Helsinki ICU cohort. Acta Anaesthesiol Scand 60:1437–1443. https://doi.org/10.1111/aas.12752

    Article  PubMed  Google Scholar 

  17. Hess E, Renzi F, Karhunen P, Dol M, Lefèvre A, Antikainen J et al (2018) Capnocytophaga canimorsus capsular serovar and disease severity, Helsinki Hospital District, Finland, 2000–2017. Emerg Infect Dis 24:2195–2201. https://doi.org/10.3201/eid2412.172060

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Chesdachai S, Tai DBG, Yetmar ZA, Misra A, Ough N, Abu Saleh O. The characteristics of Capnocytophaga infection: 10 years of experience. Open Forum Infect Dis 2021;8:ofab175. https://doi.org/10.1093/ofid/ofab175.

  19. InVS. Enquête sur les facteurs de gravité des morsures de chien 2011. /maladies-et-traumatismes/traumatismes/enquete-sur-les-facteurs-de-gravite-des-morsures-de-chien (accessed January 20, 2020).

  20. Hess E, Renzi F, Koudad D, Dol M, Cornelis GR (2017) Identification of virulent Capnocytophaga canimorsus isolates by capsular typing. J Clin Microbiol 55:1902–1914. https://doi.org/10.1128/JCM.00249-17

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Mader N, Lührs F, Langenbeck M, Herget-Rosenthal S (2020) Capnocytophaga canimorsus - a potent pathogen in immunocompetent humans - systematic review and retrospective observational study of case reports. Infect Dis (Lond) 52:65–74. https://doi.org/10.1080/23744235.2019.1687933

    Article  CAS  Google Scholar 

  22. MMWR Morb Mortal Wkly Rep. Nonfatal dog bite-related injuries treated in hospital emergency departments — United States, 2001. 2003. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5226a1.htm (accessed January 20, 2020).

  23. Campbell JR, Edwards MS (1991) Capnocytophaga species infections in children. Pediatr Infect Dis J 10:944–948. https://doi.org/10.1097/00006454-199112000-00013

    Article  CAS  PubMed  Google Scholar 

  24. Renzi F, Ittig SJ, Sadovskaya I, Hess E, Lauber F, Dol M, et al. Evidence for a LOS and a capsular polysaccharide in Capnocytophaga canimorsus. Scientific Reports 2016;6. https://doi.org/10.1038/srep38914.

  25. Mally M, Paroz C, Shin H, Meyer S, Soussoula LV, Schmiediger U et al (2009) Prevalence of Capnocytophaga canimorsus in dogs and occurrence of potential virulence factors. Microbes Infect 11:509–514. https://doi.org/10.1016/j.micinf.2009.02.005

    Article  CAS  PubMed  Google Scholar 

  26. Meyers B, Schoeman JP, Goddard A, Picard J. The bacteriology and antimicrobial susceptibility of infected and non-infected dog bite wounds: fifty cases. Veterinary Microbiology 2008;127:360–8. /https://doi.org/10.1016/j.vetmic.2007.09.004.

  27. van Duijkeren E, van Mourik C, Broekhuizen M, Leuven M, Gaastra W, Houwers D (2006) First documented Capnocytophaga canimorsus infection in a species other than humans. Vet Microbiol 118:148–150. https://doi.org/10.1016/j.vetmic.2006.07.002

    Article  PubMed  Google Scholar 

  28. Shin H, Mally M, Meyer S, Fiechter C, Paroz C, Zaehringer U et al (2009) Resistance of Capnocytophaga canimorsus to killing by human complement and polymorphonuclear leukocytes. Infect Immun 77:2262–2271. https://doi.org/10.1128/IAI.01324-08

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Meyer S, Shin H, Cornelis GR (2008) Capnocytophaga canimorsus resists phagocytosis by macrophages and blocks the ability of macrophages to kill other bacteria. Immunobiology 213:805–814. https://doi.org/10.1016/j.imbio.2008.07.019

    Article  CAS  PubMed  Google Scholar 

  30. Zangenah S, Andersson AF, Özenci V, Bergman P (2017) Genomic analysis reveals the presence of a class D beta-lactamase with broad substrate specificity in animal bite associated Capnocytophaga species. Eur J Clin Microbiol Infect Dis 36:657–662. https://doi.org/10.1007/s10096-016-2842-2

    Article  CAS  PubMed  Google Scholar 

  31. Hayani O, Higginson LAJ, Toye B, Burwash IG (2009) Man’s best friend? Infective endocarditis due to Capnocytophaga canimorsus. Can J Cardiol 25:e130-132. https://doi.org/10.1016/s0828-282x(09)70076-5

    Article  PubMed  PubMed Central  Google Scholar 

  32. Perez RE (1988) Dysgonic fermenter-2 infections. West J Med 148:90–92

    CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The GMC study group is composed of Marlène Amara, Olivier Baraud, Emmanuelle Bille, Frédérique Canis, Etienne Carbonnelle, Vincent Cattoir, Nicolas Chatelain, Elodie Collin, Stéphane Corvec, Jean-Winoc Decousser, Nicolas Degand, Tristan Diedrich, Laurent Dortet, Marie-Sarah Fangous, Eric Farfour, Vincent Fihman, Emilie Flevin, Emmanuelle Gallois, Lauraine Gauthier, Sylvain Godreuil, Antoine Grillon, Hélène Guet-Revillet, Thomas Guillard, Esther Gyde, Geneviève Héry-Arnaud, Christophe Isnard, Hervé Jacquier, Frédéric Janvier, Françoise Jaureguy, Philippe Lanotte, Frédéric Laurent, Cécile Le Brun, Alban Le Monnier, Alexandra Lomont, Audrey Merens, Philippe Morand, Assaf Mizrahi, Agathe Poisson, Gauthier Péan de Ponfilly, Benoit Pilmis, Chloé Plouzeau, Anaïs Potron, Anne-Gaëlle Ranc, Emeline Riverain-Gillet, Anne-Laure Rosey, Nathalie Soismier, Violaine Waleski, Paul-Louis Woerther, and Jean-Ralph Zahar.

Author information

Authors and Affiliations

  1. Université de Brest, Inserm, UMR 1078, Unité de Bactériologie, CHRU de Brest, 29200, Brest, France

    Clémence Beauruelle & Geneviève Héry-Arnaud

  2. Service de Bactériologie Et d’Hygiène Hospitalière, Unité de Microbiologie Moléculaire Et Séquençage, CHU de Poitiers, 86000, Poitiers, France

    Chloé Plouzeau

  3. EA7290, Plateau Technique de Microbiologie, Laboratoire de Bactériologie, Université de Strasbourg, CHU de Strasbourg, 67000, Strasbourg, France

    Antoine Grillon

  4. Normandie Univ, UNICAEN/UNIROUEN, EA2656 GRAM2.0, CHU de Caen Normandie, Service Microbiologie, 14000, Caen, France

    Christophe Isnard

  5. Service de Bactériologie-Hygiène Hospitalière, CHU de Nantes, 44049, Nantes Cedex 1, France

    Stéphane Corvec

  6. Laboratoire de Bactériologie, Hôpital L’archet 2, CHU de Nice, 06202, Nice, France

    Nicolas Degand

  7. Service de Microbiologie, Hôpitaux Universitaires Saint-Louis Lariboisière-Fernand Widal, Paris, France

    Hervé Jacquier & Gauthier Péan de Ponfilly

  8. Service de Biologie, Unité de Microbiologie, CH Versailles-Site André Mignot, Le Chesnay, France

    Marlène Amara

  9. Institut Micalis, UMR1319, Université Paris-Saclay, INRAe, AgroParisTech, Bactéries Pathogènes et Santé, Chatenay-Malabry, Service de Microbiologie clinique, GH Paris Saint-Joseph, 75014, Paris, France

    Assaf Mizrahi & Alban Le Monnier

  10. Pôle Biologie-Hygiène, 59304, Valenciennes, CH, France

    Tristan Diedrich

  11. Service de Bactériologie-Hygiène Hospitalière, CHU de Rennes, 35033, Rennes, France

    Caroline Piau

  12. Service de Biologie Clinique, Hôpital Foch, 92150, Suresnes, France

    Eric Farfour

  13. Université de Montpellier, UMR MIVEGEC IRD-CNRS-Laboratoire de Bactériologie, CHU de Montpellier, Montpellier, France

    Lucas Bonzon

  14. Service de Bactériologie-Virologie-Hygiène, Hôpital Bretonneau, CHRU de Tours, 37000, Tours, France

    Cécile Le Brun

  15. Laboratoire de Microbiologie, Hôpital Avicenne, 93000, Bobigny, France

    Violaine Walewski

  16. Laboratoire de Microbiologie, Hôpital Necker-Enfants Malades, 75015, Paris, France

    Emmanuelle Bille

  17. Service de Bactériologie-Hygiène, CHU de Bicêtre, 94270, Le Kremlin-Bicêtre, France

    Laurent Dortet

  18. Université de Reims-Champagne-Ardenne, Inserm UMR-S, 1250 P3Cell, SFR CAP-Santé, Laboratoire de Bactériologie-Virologie-Hygiène Hospitalière-Parasitologie-Mycologie, Hôpital Robert Debré, CHU Reims, 51000, Reims, France

    Thomas Guillard

  19. Laboratoire de Microbiologie, CHIC, 94000, Créteil, France

    Nathalie Soismier

  20. Unité de Bactériologie, Groupe Hospitalier Henri Mondor, 94010, Créteil, France

    Ronan Le Guen

  21. Université de Paris, Faculté de Médecine, Service de Bactériologie, Groupe Hospitalier Cochin,, 75014, Paris, France

    Philippe Morand

  22. Laboratoire de Bactériologie-Virologie, Unité INSERM UMR1078 “Genetics, Genomics and Biotechnology”, Axe Microbiota, UFR de Médecine Et Des Sciences de La Santé, 22 avenue Camille Desmoulins, 29238, Brest, France

    Geneviève Héry-Arnaud

Authors
  1. Clémence Beauruelle
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chloé Plouzeau
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Antoine Grillon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christophe Isnard
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Stéphane Corvec
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nicolas Degand
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hervé Jacquier
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Marlène Amara
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Assaf Mizrahi
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Tristan Diedrich
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Caroline Piau
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Eric Farfour
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Lucas Bonzon
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Cécile Le Brun
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Violaine Walewski
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Emmanuelle Bille
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Laurent Dortet
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Thomas Guillard
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. Nathalie Soismier
    View author publications

    You can also search for this author in PubMed Google Scholar

  20. Ronan Le Guen
    View author publications

    You can also search for this author in PubMed Google Scholar

  21. Philippe Morand
    View author publications

    You can also search for this author in PubMed Google Scholar

  22. Gauthier Péan de Ponfilly
    View author publications

    You can also search for this author in PubMed Google Scholar

  23. Alban Le Monnier
    View author publications

    You can also search for this author in PubMed Google Scholar

  24. Geneviève Héry-Arnaud
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Clémence Beauruelle and Geneviève Héry-Arnaud contributed to the study conception and design. All authors contributed to data collection and writing—reviewing and editing the manuscript. The first draft of the manuscript was written by Clémence Beauruelle and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Geneviève Héry-Arnaud.

Ethics declarations

Ethics approval

The study was approved by the ethics committee in human research of the university hospital of Brest (Brest, France; 29BRC19.0251). All experiments were performed in accordance with relevant guidelines and regulations.

Consent to participate and for publication

Informed consent was obtained from all participants and/or their legal guardians.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Beauruelle, C., Plouzeau, C., Grillon, A. et al. Capnocytophaga zoonotic infections: a 10-year retrospective study (the French CANCAN study). Eur J Clin Microbiol Infect Dis 41, 581–588 (2022). https://doi.org/10.1007/s10096-022-04402-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-022-04402-x

Keywords

Search

Navigation