Dog bite wounds and infection: A prospective clinical study

Goldstein, Ellie J. C.; Citron, Diane M.; Finegold, S M

doi:10.1016/s0196-0644(80)80188-0

Cited by 85 publications

(45 citation statements)

References 16 publications

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“…The spectr empinc therapy until specific bacteriologic information be-erythromycir comes available (5,7,9). The fixed combination of amoxicilaerobic and; lin-potassium clavulanate has been shown to be as effective against most as penicillin with or without dicloxacillin in the therapy of species, and bite wounds (12), but it was not tested in our current study.…”

Section: Methodsmentioning

confidence: 98%

Susceptibility of bite wound bacteria to seven oral antimicrobial agents, including RU-985, a new erythromycin: considerations in choosing empiric therapy

Goldstein¹,

Citron²,

Vagvolgyi³

et al. 1986

Antimicrob Agents Chemother

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The susceptibility of 93 aerobic and 59 anaerobic bacteria isolated from human and animal bite wounds was determined by agar dilution. No agent tested (penicillin, oxacillin, cephalexin, sulfamethoxazole-trimethoprim, minocycline, erythromycin, and RU-965) was consistently active against all isolates. A total of 21% of the Bacteroides species, all isolated from human bites, were resistant to penicillin; 14 and 18% of the Pasteurella multocida isolates were resistant to erythromycin and oxacillin, respectively.Bite wounds are common injuries and account for approximately 1% of all emergency room visits (5). Infectious complications are frequent and include cellulitis, septic arthritis, osteomyelitis, and even fatal sepsis. Isolates are most often those from the oral flora of the biter and include both aerobic and, in 33 to 55% of cases, anaerobic bacteria (10, 11). To date, the information available regarding the susceptibility of bacteria isolated from bite wounds comes from studies that have focused on a single organism, such as Pasteurella multocida, DF-2, or Eikenella corrodens (2,7,8,16,17). In addition, these studies have often used veterinary isolates and strains obtained from general clinical specimens other than bite wounds.We determined the susceptibility of 93 aerobic and 59 anaerobic bacteria to seven oral antimicrobial agents, including a new macrolide antibiotic, RU-985. This new agent has a structure and an antibacterial spectrum similar to that of erythromycin, but gives higher and more sustained plasma and tissue levels, according to the manufacturer (HoechstRoussel Pharmaceuticals Inc., Somerville, N.J.).The purpose of this study was (i) to use only strains isolated from bite wounds, (ii) to study recently isolated strains to look for the emergence of resistance, (iii) to study the susceptibility of these isolates to oral antibacterial agents since many of these wounds are treated with oral antibiotics and outpatient follow-up, (iv) to supply these data in a single paper since no previous study combines this information, and (v) 3. The numbers and species of isolates tested are given in Table 1.Standard laboratory powders were kindly supplied by the following companies: penicillin G, cephalexin, and erythromycin, Eli Lilly & Co., Indianapolis, Ind.; oxacillin, Bristol Laboratories, Syracuse, N.Y.; minocycline, Lederle Laboratories, Pearl River, N.Y.; sulfamethoxazole-trimethoprim (SXT), Hoffman-La Roche Inc., Nutley, N.J.; and RU-965, Hoechst-Roussel Pharmaceuticals Inc., Somerville, N.J.Strains were taken from frozen stock culture and transferred twice to ensure purity and good growth. Because of the diversity of the isolates tested, strains of various types were handled differently, according to accepted appropriate methods for the particular organism. Anaerobic bacteria were cultured and inocula were prepared by the methods outlined in the Wadsworth Anaerobic Bacteriology Manual (in press). Isolates of E. corrodens were cultured and inocula were prepared by the methodology previously estab...

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Section: Methodsmentioning

confidence: 98%

Susceptibility of bite wound bacteria to seven oral antimicrobial agents, including RU-985, a new erythromycin: considerations in choosing empiric therapy

Goldstein¹,

Citron²,

Vagvolgyi³

et al. 1986

Antimicrob Agents Chemother

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“…Newsl. 31: [1][2][3][4][5][6][7][8]1986) and at a break point representing one-half to one-quarter of the achievable peak concentrations in serum following a usual maximum oral dose of the antimicrobial agent (14,15). Discrepancies between the two break points occurred with some drugs, because the NCCLS standards are often based on levels of an agent that are achieved after parenteral administration, and we were interested in the levels that related to oral doses since most bite wounds are treated with oral antimicrobial agents.…”

Section: Methodsmentioning

confidence: 99%

“…Approximately 80% of bite wounds harbor potential pathogens, including many unusual and fastidious aerobic and anaerobic bacteria (10). Anaerobic bacteria can be isolated from approximately 30 and 60% of animal and human bite wounds, respectively (2,6,7,10), and their isolation has been associated with more severe clinical infections (11). Yet, in an era of cost-consciousness, these wounds are often not cultured aerobically and are rarely cultured anaerobically except in research studies.…”

mentioning

confidence: 99%

Comparative activities of cefuroxime, amoxicillin-clavulanic acid, ciprofloxacin, enoxacin, and ofloxacin against aerobic and anaerobic bacteria isolated from bite wounds

Goldstein¹,

Citron²

1988

Antimicrob Agents Chemother

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We studied the comparative in vitro activities of 10 oral antimicrobial agents against 147 aerobic and 61 anaerobic bacteria making up species in 13 genera (Staphylococcus aureus, streptococci, Eikenella corrodens, Pasteurella multocida, Haemophilus-Actinobacillus spp., M-5, EF-4, Moraxella spp., Flavobacterium Ilb, Bacteroides melaninogenicus, Bacteroides spp., Fusobacterium spp., and Peptostreptococcus spp.) that were isolated from bite wounds. Cefuroxime was generally >fourfold more active than cephalexin and cefadroxil against all aerobic isolates, including Pasteurella multocida. The fluoroquinolones were highly active against most aerobic isolates but were less active against anaerobic isolates. Ciprofloxacin was generally more active than either enoxacin or ofloxacin. Discrepancies of >30% in the interpretation of susceptibilities between break points suggested by the National Committee for Clinical Laboratory Standards and those related to oral dose peak levels (one-half to one-quarter of maximum achievable concentrations) were noted in 14% (18 of 130) of the instances.The choice of an appropriate antimicrobial regimen for infections caused by animal and human bites poses a dilemma for clinicians. Approximately 80% of bite wounds harbor potential pathogens, including many unusual and fastidious aerobic and anaerobic bacteria (10). Anaerobic bacteria can be isolated from approximately 30 and 60% of animal and human bite wounds, respectively (2, 6, 7, 10), and their isolation has been associated with more severe clinical infections (11). Yet, in an era of cost-consciousness, these wounds are often not cultured aerobically and are rarely cultured anaerobically except in research studies. To compound these problems, most clinical laboratories are unable to determine the in vitro susceptibilities of fastidious aerobic and anaerobic bacteria that are frequently isolated from bite wounds.Consequently, clinicians must sometimes rely on the medical literature to guide therapeutic choices, both empiric and specific. Only two systematic susceptibility studies with large numbers and varieties of bite pathogens exist in the English language literature (2, 9). In these studies both a high percentage of 3-lactamase-producing bacteria (2) and the emergence of bacteria that are resistant to commonly used antimicrobial agents have been noted in several genera of isolates obtained from bite wounds (9). Information about newer alternative therapeutic agents and their in vitro activities against the full spectrum of species isolated from bite wounds is therefore needed to help guide clinicians.Cefuroxime axetil, the new orally administered, esterified formulation of cefuroxime, and ciprofloxacin, an oral fluoroquinolone antibacterial agent, have recently been approved for use in skin and soft tissue infections. Ofloxacin and enoxacin are two other oral fluoroquinolones under investigation that have potential use in skin and soft tissue infections. Since these agents can be used to treat animal and human bite wound infections...

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“…The microbiology of infected bite wounds from dogs is similar to that of the organisms that colonize the dog's oral cavity (7,23,85,90,91,93,96,192,195). Less frequently, isolates may also come from the environment and patients' skin.…”

Section: Mammalsmentioning

confidence: 99%

Microbiology of Animal Bite Wound Infections

2011

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SUMMARY The microbiology of animal bite wound infections in humans is often polymicrobial, with a broad mixture of aerobic and anaerobic microorganisms. Bacteria recovered from infected bite wounds are most often reflective of the oral flora of the biting animal, which can also be influenced by the microbiome of their ingested prey and other foods. Bacteria may also originate from the victim's own skin or the physical environment at the time of injury. Our review has focused on bite wound infections in humans from dogs, cats, and a variety of other animals such as monkeys, bears, pigs, ferrets, horses, sheep, Tasmanian devils, snakes, Komodo dragons, monitor lizards, iguanas, alligators/crocodiles, rats, guinea pigs, hamsters, prairie dogs, swans, and sharks. The medical literature in this area has been made up mostly of small case series or case reports. Very few studies have been systematic and are often limited to dog or cat bite injuries. Limitations of studies include a lack of established or inconsistent criteria for an infected wound and a failure to utilize optimal techniques in pathogen isolation, especially for anaerobic organisms. There is also a lack of an understanding of the pathogenic significance of all cultured organisms. Gathering information and conducting research in a more systematic and methodical fashion through an organized research network, including zoos, veterinary practices, and rural clinics and hospitals, are needed to better define the microbiology of animal bite wound infections in humans.

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Dog bite wounds and infection: A prospective clinical study

Cited by 85 publications

References 16 publications

Susceptibility of bite wound bacteria to seven oral antimicrobial agents, including RU-985, a new erythromycin: considerations in choosing empiric therapy

Susceptibility of bite wound bacteria to seven oral antimicrobial agents, including RU-985, a new erythromycin: considerations in choosing empiric therapy

Comparative activities of cefuroxime, amoxicillin-clavulanic acid, ciprofloxacin, enoxacin, and ofloxacin against aerobic and anaerobic bacteria isolated from bite wounds

Microbiology of Animal Bite Wound Infections

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