Wound infections secondary to snakebite

Garg, Atul; Sujatha, S.; Garg, Jaya; Acharya, N Srinivas; Parija, Subhash Chandra

doi:10.3855/jidc.39

Cited by 75 publications

(90 citation statements)

References 5 publications

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“…10,22,23 The bacterial compositions vary among snake species and may be influenced by venom properties 9,19,24 and the fecal flora of the prey in different geographic regions. 23 Laboratory bacteriological investigations of aerobic isolates from the venom and oral cavities of the North American pit viper Crotalus atrox demonstrated a preponderance of enteric and coliform organisms, particularly Aerobacter, Proteus, and Pseudomonas, with Clostridium as the most common anaerobic genus.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6] Although studies of the oral bacteriology of N. atra have been conducted in Hong Kong,7,8 little is known about snakebite wound bacteriology and the effects of geographic differences in the same species. [9][10][11] To better understand the bacteriology of N. atra bite wounds, we retrospectively analyzed 112 cases from two referring medical centers: Taichung Veterans General Hospital (VGH-TC) in central Taiwan and Taipei Veterans General Hospital (VGH-TP) in northern Taiwan.…”

Section: Introductionmentioning

confidence: 99%

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Bacteriology of Naja atra Snakebite Wound and Its Implications for Antibiotic Therapy

Mao¹,

Liu²,

Hung³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. A total of 112 cases of Naja atra envenomation were examined at two referring hospitals: Taichung Veterans General Hospital in central Taiwan and Taipei Veterans General Hospital (VGH-TP) in northern Taiwan. Overall, 77% (86/112) of cases developed clinically suspected wound infections and 54% (61/112) required surgery secondary to tissue necrosis, finger or toe gangrene, and/or necrotizing fasciitis. Morganella morganii was the most abundant gramnegative bacterial strain isolated from bite wounds, followed by Proteus spp., Aeromonas hydrophila, Pseudomonas aeruginosa, and Providencia spp. in descending order; Enterococcus spp. were the most common gram-positive bacteria and Bacteroides spp. were the only anaerobic bacteria. A few episodes of bacteremia were caused by Bacteroides and Shewanella spp. There were no significant variations in the distribution of bacterial species between these two hospitals except for a higher incidence of M. morganii, Enterococcus spp., and polymicrobial infection observed at VGH-TP, which may have been related to variations in the fecal flora of prey and oral flora of individual snakes in different geographic areas in Taiwan. According to the susceptibility test involving various pathogens, first-line drug options for the management of N. atra snakebite wound infections may include monotherapy with ureidopenicillin or combination therapy with aminopenicillin and a third-generation cephalosporin or fluoroquinolone. A prospective evaluation of empiric antibiotic therapy for the management of N. atra snakebite should be considered.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bacteriology of Naja atra Snakebite Wound and Its Implications for Antibiotic Therapy

Mao¹,

Liu²,

Hung³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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“…In areas of high snakebite prevalence outside SA, a similar spectrum of bacterial species has been found and antibiotic sensitivities reported. [6][7][8][9] The bacterial cause of infected snakebite wounds in northern KZN has been determined by previous work, but antibiotic susceptibility remains untested. A current description of associated morbidity is also required.…”

Section: Researchmentioning

confidence: 99%

Wound infection secondary to snakebite

2017

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Background. Snakebites can produce severe local and systemic septic complications as well as being associated with significant overall morbidity and even mortality. Objective. A prospective audit was undertaken to determine the bacterial causation of wound infection secondary to snakebite, and attempt to quantify the burden of disease. Methods. The audit was undertaken at Ngwelezane Hospital, which provides both regional and tertiary services for north-eastern KwaZuluNatal Province, South Africa, over a 4-month period. Records of patients who required surgical debridement for extensive skin and softtissue necrosis were analysed. At the time of debridement, tissue samples of necrotic or infected tissue were sent for bacteriological analysis as standard of care. Microbiology results were analysed. Results. A total of 164 patients were admitted to hospital for management of snakebite, of whom 57 required surgical debridement and 42 were included in the final microbiological analysis. Children were found to be the most frequent victims of snakebite; 57.8% of patients in this study were aged ≤10 years and 73.7% ≤15 years. Culture showed a single organism in 32/42 cases, two organisms in 8 and no growth in 2. Eight different types of organisms were cultured, five of them more than once. Thirty-five specimens (83.3%) grew Gram-negative Enterobacteriaceae, the most frequent being Morganella morganii and Proteus species. Thirteen specimens (31.0%) grew Enterococcus faecalis. Gram-negative Enterobacteriaceae showed 31.4% sensitivity to ampicillin, 40.0% sensitivity to amoxicillin plus clavulanic acid, 34.3% sensitivity to cefuroxime, 97.1% sensitivity to ceftriaxone, and 100% sensitivity to ciprofloxacin, gentamicin and amikacin. E. faecalis was 92.3% sensitive to amoxicillin, 92.3% sensitive to amoxicillin plus clavulanic acid, 100% sensitive to ciprofloxacin, 92.3% resistant to erythromycin and 100% resistant to ceftriaxone. Conclusion. Children are particularly vulnerable to snakebite, and the consequences can be devastating. While the majority of patients in this study were shown to have secondary bacterial infection, debridement and subsequent wound management is considered the mainstay of treatment. Common organisms are Enterobacteriaceae and enterococci. There appears to be a role for antibiotics in the management of these patients. A good antibiotic policy is strongly advocated.

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“…Non-venomous snakes may also harbor a wide range of bacteria in their oral cavity able to complicate the bite wounds (DIPINETO M. Lukač et al: Oral and cloacal aerobic microflora of four-lined snakes (Elaphe quatuorlineata) from Croatia et al, YAK et al, 2015) so the information on their microflora should not be neglected. Secondary bacterial infections, such as subcutaneous abscess or tetanus, are possible complications of snake bites, either venomous or non-venomous snakes (HABIB, 2002;GARG et al, 2009). In addition to bites, humans can be infected during manipulation of animals (RABINOWITZ et al, 2007;DEKKER and FRANK, 2015) or via infected equipment (FOSTER and KERR, 2005).…”

Section: Introductionmentioning

confidence: 99%

Oral and cloacal aerobic bacterial and fungal flora of free-living four-lined snakes (Elaphe quatuorlineata) from Croatia

Lukač

Tomić

Mandac³

et al. 2017

Vet.arhiv

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The aim of this study was to identify oral and cloacal aerobic flora of four-lined snakes (Elaphe quatuorlineata) from Croatian islands Cres and Olib to get better insight into bacteria and fungi potentially harmful to both the animals and the people getting in contact with those animals. Oral and cloacal swabs were taken from a total of 20 snakes and analyzed by standard microbiology and by Real-Time PCR method for Chlamydia spp. identification. Neither Salmonella spp. nor Chlamydia spp. were detected, but some potentially human pathogens, such as Aeromonas hydrophila, Escherichia coli, Serratia marcescens and Stenotrophomonas maltophilia, were isolated. Some of fungi detected, such as Candida albicans, Aspergillus flavus and Cladosporium sp., have already been described as secondary causative disease agents in reptile collections. To the author's knowledge this study is the first survey of aerobic microflora of four-lined snakes.

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Wound infections secondary to snakebite

Cited by 75 publications

References 5 publications

Bacteriology of Naja atra Snakebite Wound and Its Implications for Antibiotic Therapy

Bacteriology of Naja atra Snakebite Wound and Its Implications for Antibiotic Therapy

Wound infection secondary to snakebite

Oral and cloacal aerobic bacterial and fungal flora of free-living four-lined snakes (Elaphe quatuorlineata) from Croatia

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