Ngo Ngoc Duc, Le Quy Xuan, Pham Anh Quang, Nguyen Nguyen Trung, Ha Hung Tran, Dinh Michael Minh Quoc, Le Thuan Quang
Department of Emergency and Poison Control, Hanoi Medical University, Hanoi, Vietnam; Emergency Department, Bach Mai Hospital, Hanoi, Vietnam.
Department of Emergency and Poison Control, Hanoi Medical University, Hanoi, Vietnam.
Wilderness Environ Med. 2020 Jun;31(2):151-156. doi: 10.1016/j.wem.2020.01.002. Epub 2020 Apr 22.
Clinical and bacteriological features of cobra (Naja) bites are still relatively unknown in Vietnam. This study aimed to characterize the clinical and bacteriological characteristics of local wounds in patients with presumed Naja spp bite, as well as their antibiotic treatment.
A cross-sectional study was performed on presumed Naja bite patients who were admitted to Bach Mai Hospital in Hanoi, Vietnam. In vitro bacterial isolation, blood tests, and lesion measure were conducted, and antibiotic susceptibilities of localized bite wounds were assessed. The Mann-Whitney test was used to examine the difference in clinical characteristics between patients experiencing presumed Naja atra bites and Naja kaouthia bites. Data are presented as percentages or median with interquartile range, as appropriate. Statistical significance was accepted at P<0.05.
Among 46 patients, all had typical clinical features of Naja bite. The median bite-to-hospital time was 6 h (interquartile range 4.0-11.3). The dominant organisms isolated from local wounds were Morganella morganii (11/36) and Enterococcus faecalis (25/36). All cultures were susceptible to ciprofloxacin. No difference was found with regard to pain, swelling circumference, swelling spread, or necrotic area between patients bitten by presumed Naja atra and Naja kaouthia (P>0.05).
Wound necrosis and infection were important clinical issues in presumed Naja spp snake bites. Morganella morganii and Enterococcus faecalis were dominant in local wound swabs of such cases. Ciprofloxacin should be an effective first-line antibiotic for patients with presumed Naja bite.
在越南，眼镜蛇（眼镜蛇属）咬伤的临床和细菌学特征仍相对不为人知。本研究旨在描述疑似眼镜蛇属咬伤患者局部伤口的临床和细菌学特征，以及他们的抗生素治疗情况。
对越南河内巴维医院收治的疑似眼镜蛇咬伤患者进行了一项横断面研究。进行了体外细菌分离、血液检查和伤口测量，并评估了局部咬伤伤口的抗生素敏感性。采用曼-惠特尼检验来检查疑似中华眼镜蛇咬伤患者和眼镜王蛇咬伤患者之间临床特征的差异。数据以百分比或中位数及四分位间距的形式呈现，视情况而定。P<0.05时接受统计学显著性。
46例患者均具有典型的眼镜蛇咬伤临床特征。咬伤至入院的中位时间为6小时（四分位间距4.0 - 11.3）。从局部伤口分离出的主要细菌是摩根氏摩根菌（11/36）和粪肠球菌（25/36）。所有培养物对环丙沙星敏感。在疑似被中华眼镜蛇和眼镜王蛇咬伤的患者之间，在疼痛、肿胀周长、肿胀范围或坏死面积方面未发现差异（P>0.05）。
伤口坏死和感染是疑似眼镜蛇属蛇咬伤的重要临床问题。摩根氏摩根菌和粪肠球菌在这类病例的局部伤口拭子中占主导地位。环丙沙星应该是疑似眼镜蛇咬伤患者有效的一线抗生素。
