Bacterial infection in association with snakebite: A 10-year experience in a northern Taiwan medical center

Chen, Chun‐Ming; Wu, Keh-Gong; Chen, Chun‐Jen; Wang, Chuang-Ming

doi:10.1016/j.jmii.2011.04.011

Cited by 78 publications

(93 citation statements)

References 8 publications

(7 reference statements)

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“…No significant differences between two islands in the number or type of bacteria were noted. Most of the isolated Gram-negative, opportunistic microflora has already been described as a potential cause of diseases in animals and humans (DRAPER et al, 1981;HARRIS and ROGERS, 2001;CHEN et al, 2011). Considering an increasing popularity of reptiles in Croatia, this aspect of human infection should not be overlooked.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…16 Similar results were also described in a previous study in western Taiwan. 17 Hence, the use of adequate antibiotics is important in N atra envenomation management. In accordance with the results of our tests of the antibiotic susceptibility of the isolated bacteria, treatment with glycopeptide antibiotics (vancomycin or teicoplanin) combined with a third-generation cephalosporin (cefotaxime) with or without anti-anaerobic antibiotics (clindamycin or metronidazole) is recommended.…”

Section: Discussionmentioning

confidence: 99%

“…Overall, the surgical patients received significantly higher doses of antivenin (9.2 ± 4.9 vials vs 3.8 ± 2.4 vials; P=0.002) and had significantly higher white blood cell counts (11.0 ± 3.7 × 10 9 /L vs 8.2 ± 2.4 × 10 9 /L; P=0.043). A higher respiratory rate was also evident in surgical patients (median [interquartile range]: 20 [20-21] vs 18 [16][17][18] breaths/min; P=0.015), but the incidence of missing data in both groups for this factor was high (Table …”

Section: Demographic and Clinical Characteristics Associated With Surmentioning

confidence: 99%

Can surgical need in patients with Naja atra (Taiwan or Chinese cobra) envenomation be predicted in the emergency department?

Wang

et al. 2016

Hong Kong Med J

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Objectives:To investigate the clinical predictors and the aetiologies for surgery in patients with Naja atra (Taiwan or Chinese cobra) envenomation.Methods: This case series was conducted in the only tertiary care centre in eastern Taiwan. Patients who presented to the emergency department with Naja atra bite between January 2008 and September 2014 were included. Clinical information was collected and compared between surgical and non-surgical patients.Results: A total of 28 patients with Naja atra envenomation presented to the emergency department during the study period. Of these, 60.7% (n=17) required surgery. Necrotising fasciitis (76.5%) was the main finding in surgery. Comparisons between surgical and non-surgical patients showed skin ecchymosis (odds ratio=34.36; 95% confidence interval, 2.20-536.08; P=0.012) and a high total dose of antivenin (≥6 vials; odds ratio=14.59; 95% confidence interval, 1.10-192.72; P=0.042) to be the most significant predictors of surgery. The rate of bacterial isolation from the surgical wound was 88.2%. Morganella morganii (76.5%), Enterococcus faecalis (58.8%), and Bacteroides fragilis (29.4%) were the most common pathogens involved. Bacterial susceptibility testing indicated that combined broadspectrum antibiotics were needed to cover mixed aerobic and anaerobic bacterial infection.

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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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Bacterial infection in association with snakebite: A 10-year experience in a northern Taiwan medical center

Cited by 78 publications

References 8 publications

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

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

Can surgical need in patients with Naja atra (Taiwan or Chinese cobra) envenomation be predicted in the emergency department?

Wound infection secondary to snakebite

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