Wound infections secondary to snakebite in central Taiwan

• Published in: Journal of Venomous Animals and Toxins including Tropical Diseases
• Main Authors: Li-Wen Huang, Jiaan-Der Wang, Jin-An Huang, Sung-Yuan Hu, Lee-Min Wang, Yu-Tse Tsan
• Format: Article in Journal/Newspaper
• Language: English
• Published: SciELO 2012
• Subjects: snakebite; antivenom; venomous; cobra; bacterial infection; bacterial resistance; Taiwan; Arctic medicine. Tropical medicine; RC955-962; Toxicology. Poisons; RA1190-1270; Zoology; QL1-991; Arctic
• Online Access: https://doi.org/10.1590/S1678-91992012000300004; https://doaj.org/article/42d5ff1dae4a48cfa02c7285ff111050

There are very few microbiological data on wound infections following snakebites. The objective of this study was to investigate the treatment of secondary infection following snakebites in central Taiwan. Microbiological data and antibiotic sensitivity of wound cultures were retrospectively analyzed from December 2005 to October 2007 in a medical center in central Taiwan. A total of 121 snakebite patients participated in the study. Forty-nine (40.5%) subjects were bitten by cobra (Naja atra); 34 of them had secondary infection, and 24 of them (70.6%) needed surgical intervention. Cobra bites caused more severe bacterial infection than other snakebites. Morganella morganii was the most common pathogen, followed by Aeromonas hydrophila and Enterococcus. Gram-negative bacteria were susceptible to amikacin, trimethoprim/sulfamethoxazole, cefotaxime, cefepime, ciprofloxacin, and piperacillin/tazobactam. Enterococcus were susceptible to ampicillin, gentamicin, penicillin and vancomycin. It is reasonable to choose piperacillin/tazobactam, quinolone, second- or third-generation cephalosporin for empirical therapy following snakebite. Surgical intervention should be considered for invasive soft tissue infections.