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

J Microbiol Immunol Infect. 2011 Dec;44(6):456-60. doi: 10.1016/j.jmii.2011.04.011. Epub 2011 Jun 22.

Abstract

Background: Microbiological data of secondary wound infections following snakebites is rarely reported in Taiwan. The objective of this study was to assess the secondary wound infection after venomous snakebites.

Methods: We conducted a 10-year retrospective survey on patients admitted for venomous snakebites and microbiological data of wound cultures at a medical center in northern Taiwan.

Results: Between April 2001 and April 2010, 231 patients who experienced snakebites were included. Male predominated, accounting for 62.3% (144). The age range of patients was 4-95 years. Ninety-five (41.1%) people were bitten by Trimeresurus mucrosquamatus, followed by Tstejnegeri, and cobra. A total of 61 pathogens were obtained from 21 patients. Thirty-nine (63.9%) isolates were gram-negative bacteria, 14 (23%) gram-positive pathogens, and 8 (13.1%) anaerobic pathogens. There were 17 patients bitten by cobra in these 21 patients. Morganella morganii and Enterococcus species were the most common pathogens identified in the wound cultures.

Conclusion: Cobra bite causes more severe bacterial infection than other kinds of snakebites. Oral amoxicillin/clavulanate plus ciprofloxacin or parenteral piperacillin/tazobactam alone can be the choices for empirical or definitive treatment, and surgical intervention should be considered for established invasive soft tissue infections.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Animals
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Infections / drug therapy
  • Bacterial Infections / microbiology*
  • Child
  • Child, Preschool
  • Elapidae
  • Enterococcus / drug effects
  • Enterococcus / isolation & purification
  • Female
  • Humans
  • Infant
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Morganella morganii / drug effects
  • Morganella morganii / isolation & purification
  • Retrospective Studies
  • Snake Bites / microbiology*
  • Taiwan
  • Viperidae

Substances

  • Anti-Bacterial Agents