Bacteriological Studies of Venomous Snakebite Wounds in Hangzhou, Southeast China

Abstract

Snakebite is a common occurrence in Hangzhou, and identifying bacteria in wounds is very important for snakebite treatment. To define the pattern of wound bacterial flora of venomous snakebites and their susceptibility to common antibiotics, we reviewed the medical charts of patients admitted with snakebite at Hangzhou TCM Hospital from January 2019 to December 2020. A total of 311 patients were enrolled in this study. Among them, bacteria culture was positive in 40 patients, and 80 organisms were isolated. The most frequent pathogens were Morganella morganii and Staphylococcus aureus. According to the results of susceptibility testing, a majority of the isolates were resistant to some common first-line antibiotics, such as ampicillin, ampicillin/sulbactam, amoxicillin/clavulanic acid, cefoxitin, and cephazolin. Quinolones, however, have shown a better antibacterial effect. In conclusion, snakebite wounds involve a wide range of bacteria. Fluoroquinolones, such as levofloxacin and ciprofloxacin, could be an alternative for empirical treatment in patients with snakebite when the effect of other antibiotics is poor.

The Incidence of Infection Complicating Snakebites in Tropical Australia: Implications for Clinical Management and Antimicrobial Prophylaxis

“…Tese high reported rates of superinfection have led to some authors suggesting that routine antibiotic prophylaxis could be considered to prevent infection following snakebite envenomation particularly in necrotic wounds in resourcelimited settings [4,8,[18][19][20][21]. However, as many snake venoms cause signifcant local tissue injury and infammation-a result of specifc enzymes in the venom and the resulting local infammatory response-the incremental contribution of bacterial secondary infection to venommediated tissue injury, and therefore utility of antibiotic therapy, is uncertain.…”