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

IF 2.1 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Journal of Tropical Medicine Pub Date : 2023-10-12 eCollection Date: 2023-01-01 DOI:10.1155/2023/5812766
Laura K Smith, John Vardanega, Simon Smith, Julian White, Mark Little, Josh Hanson
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引用次数: 0

Abstract

Objective: To define the incidence of infection following snakebite in tropical Australia and the resulting implications for the routine prescription of prophylactic antibiotics.

Methods: A retrospective study of all individuals presenting to Cairns Hospital, a tertiary referral hospital in tropical Australia, after a snakebite between December 2013 and October 2020.

Results: There were 732 hospitalisations, 720 (98.4%) patients presented within 8 hours of the snakebite, and 29/732 (4.0%) were envenomated. Envenomated patients were more likely to receive empirical antibiotics than nonenvenomated patients (8/29 (27.6%) versus 14/703 (2.0%), p < 0.001), although this was frequently as a bundle of care for critically ill individuals. Superficial skin infection was diagnosed by clinicians in 6/732 (0.8%) patients during their hospitalisation; infection was diagnosed more commonly in envenomated than in nonenvenomated patients (3/29 (10.3%) versus 3/703 (0.4%), p = 0.001). All 3 envenomated individuals diagnosed with infection were believed to have taipan (genus Oxyuranus) bites. Five (83%) of the six patients diagnosed with infection had received empirical antibiotics at presentation; only 1/710 (0.1%) patients who received no antibiotics developed a (superficial) infection.

Conclusion: Infection is a very uncommon complication of snakebite in tropical Australia. Individuals bitten by snakes in tropical Australia should not routinely receive antibiotic prophylaxis.

Abstract Image

澳大利亚热带地区蛇咬伤并发感染的发生率:对临床管理和抗菌预防的启示。
目的:确定澳大利亚热带地区毒蛇咬伤后的感染发生率,并对预防性抗生素的常规处方产生影响。方法:对2013年12月至2020年10月期间澳大利亚热带地区三级转诊医院凯恩斯医院的所有患者进行回顾性研究。结果:共有732人住院,720名(98.4%)患者在8 其中29/732(4.0%)被毒杀。包膜患者比非包膜患者更有可能接受经验性抗生素治疗(8/29(27.6%)对14/703(2.0%),p<0.001),尽管这通常是危重患者的一揽子护理。临床医生在住院期间诊断出6/732(0.8%)患者的浅表皮肤感染;与非感染者相比,感染者更常见(3/29(10.3%)对3/703(0.4%),p=0.001)。所有3名被诊断为感染的感染者都被认为有大班(氧化铀属)叮咬。六名被诊断为感染的患者中有五名(83%)在就诊时接受了经验性抗生素治疗;只有1/710(0.1%)未接受抗生素治疗的患者出现(浅表)感染。结论:在澳大利亚热带地区,感染是一种非常罕见的毒蛇咬伤并发症。在澳大利亚热带地区,被蛇咬伤的人不应常规接受抗生素预防。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Tropical Medicine
Journal of Tropical Medicine Immunology and Microbiology-Parasitology
CiteScore
3.90
自引率
4.50%
发文量
0
审稿时长
14 weeks
期刊介绍: Journal of Tropical Medicine is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies on all aspects of tropical diseases. Articles on the pathology, diagnosis, and treatment of tropical diseases, parasites and their hosts, epidemiology, and public health issues will be considered. Journal of Tropical Medicine aims to facilitate the communication of advances addressing global health and mortality relating to tropical diseases.
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