Goldstein E J, Citron D M, Finegold S M
Ann Emerg Med. 1980 Oct;9(10):508-12. doi: 10.1016/s0196-0644(80)80188-0.
We prospectively studied 26 patients with 27 dog bite wounds who sought medical attention in the emergency department. Two distinct populations were found (Fishers Exact Test, P less than or equal to 0.001): 1) those who presented 8 hr to 12 hr post-injury were concerned about rabies or tetanus or surgical wound repair; and 2) those who presented more than 12 hr post-injury were concerned with infection. There was no difference (P > 0.05) in the bacteriology of the two groups. Of all wounds, 74% had aerobic pathogens isolated, including Streptococcus viridans (12 strains), Staphylococcus aureus (five strains), and Pasteurella multocida (eight strains); 41% had anaerobic pathogens isolated, including Bacteriodes species (five strains) and Fusobacterium species (five strains). Gram stains made from wound swabs were specific but insensitive predictor for bacterial growth. Empiric outpatient therapy with oral penicillin (17 patients) and/or dicloxacillin (four patients) was effective.
我们前瞻性地研究了27处犬咬伤伤口的26例患者，这些患者在急诊科寻求医疗护理。发现了两个不同的群体（Fisher精确检验，P≤0.001）：1）受伤后8小时至12小时就诊的患者担心狂犬病、破伤风或手术伤口修复；2）受伤后超过12小时就诊的患者担心感染。两组的细菌学检查无差异（P>0.05）。在所有伤口中，74%分离出需氧病原体，包括草绿色链球菌（12株）、金黄色葡萄球菌（5株）和多杀巴斯德菌（8株）；41%分离出厌氧病原体，包括拟杆菌属（5株）和梭杆菌属（5株）。伤口拭子的革兰氏染色是细菌生长的特异性但不敏感的预测指标。口服青霉素（17例患者）和/或双氯西林（4例患者）的经验性门诊治疗有效。
