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Volume 44, Number 6, December 2011

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


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


Received: June 10, 2010    Revised: July 25, 2010    Accepted: August 31, 2010   

 

Corresponding author:
  • Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan
  • Department of Pediatrics, National Yang-Ming University, Taipei, Taiwan
  • Corresponding Author InformationCorresponding author. Department of Pediatrics, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan.
  • Chun-Ming Chen and Keh-Gong Wu contributed equally to this work.

 



 

Background and purpose: 

 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 byTrimeresurus 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.



 

Key words:

 Bacterial infectionCobraSnakebite