Department of Vascular Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China.
Department of Clinical Laboratory, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China.
Am J Trop Med Hyg. 2022 Sep 6;107(4):925-929. doi: 10.4269/ajtmh.21-1314. Print 2022 Oct 12.
Snakebite is a common occurrence in Hangzhou, and identifying bacteria in wounds is very important for snakebite treatment. To define the pattern of wound bacterial flora of venomous snakebites and their susceptibility to common antibiotics, we reviewed the medical charts of patients admitted with snakebite at Hangzhou TCM Hospital from January 2019 to December 2020. A total of 311 patients were enrolled in this study. Among them, bacteria culture was positive in 40 patients, and 80 organisms were isolated. The most frequent pathogens were Morganella morganii and Staphylococcus aureus. According to the results of susceptibility testing, a majority of the isolates were resistant to some common first-line antibiotics, such as ampicillin, ampicillin/sulbactam, amoxicillin/clavulanic acid, cefoxitin, and cephazolin. Quinolones, however, have shown a better antibacterial effect. In conclusion, snakebite wounds involve a wide range of bacteria. Fluoroquinolones, such as levofloxacin and ciprofloxacin, could be an alternative for empirical treatment in patients with snakebite when the effect of other antibiotics is poor.
蛇伤在杭州较为常见，对伤口细菌进行鉴定对蛇伤治疗非常重要。为明确毒蛇咬伤伤口细菌菌群谱及其对常见抗生素的敏感性，我们回顾性分析了 2019 年 1 月至 2020 年 12 月杭州市中医院收治的蛇伤患者的病历资料。共纳入 311 例患者，其中 40 例患者的细菌培养阳性，共分离出 80 株细菌。最常见的病原体为摩根摩根菌和金黄色葡萄球菌。药敏试验结果显示，大部分分离菌对氨苄西林、氨苄西林/舒巴坦、阿莫西林/克拉维酸、头孢西丁、头孢唑林等常用一线抗生素耐药，而喹诺酮类药物具有较好的抗菌作用。总之，蛇伤伤口涉及多种细菌，当其他抗生素效果不佳时，氟喹诺酮类药物（如左氧氟沙星和环丙沙星）可作为蛇伤患者经验性治疗的替代药物。
