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Shark bite injury sustained by a 32-year-old male (who provided informed consent for the publication of the images). A: Right hand, dorsum puncture wounds. B: Right hand, web-space laceration. C: Healed wounds, shark teeth retrieved from the wound for scale.
Source publication
Objective: To define the microbiological characteristics of animal bites in tropical Australia and the appropriateness of current Australian antimicrobial guidelines for their management.
Methods: This retrospective audit examined hospitalisations in tropical Australia following an animal bite or animal-associated penetrating injury, between 2013...
Context in source publication
Context 1
... the 2740 potential cases identified, 1745 animal encounters occuriing in 1716 individuals were eligible for inclusion (supplementary Figure 1). A total of 1035/1745 (59%) cases were male; male patients were younger than female patients (median (interquartile range (IQR)) age: 34 (20-51) versus 40 (22-55) years, p = 0.001, Supplementary Figure 2). ...
Citations
... 11 The WHO estimates that more than half of all medicines are prescribed, dispensed or sold inappropriately. 11 The median age of the patients was similar to that found in Australia (33 years) 12 and another study from Colombia (31.7 years) 4 but lower than that reported in other countries (41.0-52.0 years), [13][14][15][16] with a predominance of men, as identified in the different studies (59.3-80.8%). ...
... years), [13][14][15][16] with a predominance of men, as identified in the different studies (59.3-80.8%). 4,[12][13][14][15][16][17][18][19][20][21][22][23][24][25] In this cohort of patients, the genus of the snake that was most identified was Bothrops, which is consistent with the epidemiological surveillance data of the country. 4,5 A third of all patients could not identify the genus of the snake, a difficulty that also occurs in other countries but in higher proportions (49.0-54.7%). ...
... 26 The wounds occurred mainly in the lower limbs, and the patients reported predominantly pain and edema in the bite area, which is consistent with what has been reported in the literature. 4,[12][13][14]18,21,22,25,27 The use of traditional practices and tourniquets were common behaviors in the out-of-hospital management of some patients, which is consistent with what has been described in other communities. 5,7,9,22,23,25 However, these approaches have not proven effective and can lead to complications. 2 The ophidian accident was classified in most cases in the mild or moderate category, which is in line with that reported in other international studies (73.6-97.2%) ...
Introduction
Millions of snake bites occur worldwide each year. Clinical practice guidelines generally do not recommend the use of prophylactic antibiotics.
Objective
To determine the sociodemographic, clinical, and pharmacological variables and the use of antibiotics in a group of patients with snake bites in Colombia.
Methods
A retrospective cross-sectional study was carried out. Patients affiliated with a Colombian health insurer who presented with snake bites between 2015 and 2022 were included. The cases were identified from the National Public Health Surveillance System. Sociodemographic, clinical and pharmacological variables were identified. Descriptive and bivariate analyses were performed.
Results
A total of 643 patients were analyzed, with a median age of 30.8 years, and 74.7% were men. The most frequently identified genus of snake was Bothrops (88.8%), and most incidents were classified as mild ophidian accidents (61.6%). A total of 59.7% of patients received snake antivenom. A total of 13.8% and 2.2% of the patients had cellulitis or abscesses, respectively. A total of 63.5% received antibiotics (50.6% for prophylaxis and 12.9% for treatment), especially cephalexin (25.9%), and most of the antibiotic management was considered inappropriate (91.7%).
Conclusion
Most patients with snake bites received antibiotics, especially for prophylactic purposes, a clinical behavior that goes against current evidence. The use of antibiotics with an unsuitable spectrum for the microorganisms that are usually found in the wounds of these patients is frequent. The development of local clinical practice guidelines is required to help reduce the overprescription of antibiotics, as the excessive use of antimicrobials is the main determinant of antimicrobial resistance.
... Risk factors for infection were recorded using Australian national guidelines for the management of animal bites as a guide [24]. Tese included delay in seeking medical attention for ≥8 hours after the initial snakebite, the site of the bite, the presence of a foreign body or soiling, and the involvement of deeper tissues [25]. Complications of the bite including intensive care unit (ICU) admission or death were also recorded. ...
... Te lower rate of infection in our cohort may also be explained by diferences between the fangs of Australian elapids and other snake species. Te fangs of Australian elapids are relatively small and fxed, compared to the fangs of Bothrops species which are large and more likely to cause deeper puncture wounds, thereby increasing the risk of infection [25,33]. ...
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.
... All of the cases who suffered from laceration, and needed antibiotics were the once bitten by a dog. On contrary to our results, a study was conducted in Australia, reported a significant relation between cat-related injury and increased risk of infection 19 . A possible reason for the huge difference between that study and ours was higher numbers of victims in the former study when compared with ours. ...
Objective: The aim of this study was to investigate the epidemiology of dog and cat bite cases in Bursa, Turkey through 2018–2022. Materials and Methods: A retrospective patient review was carried out. This study was conducted in the department of the Emergency Medicine of Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey. The injury patterns and epidemiologic data of the patients were evaluated. A total of 92 animal bite cases were reviewed. Results and Conclusion: This study was enrolled 49 men (53.3%) and 43 women (46.7%) with an average age of 37.09± 16.65 years. None of them died as a consequence of animal bite. The findings indicate that a significant correlation was found between the site of injury, the type of wound, antibiotic use, and the species of the biting animals [(p=0.001), (p
... 3 In instances where severe dog bite injuries are sustained, infection commonly complicates these wounds due to the exposed tissue being in contact with pathogens from human skin flora and the oral flora of the dog. 6 Bacterial infections associated with dog bites include tetanus and capnocytophaga. Patients infected with tetanus present with symptoms such as cramping in the jaw, muscle spasms (usually in the stomach) and muscle stiffness, while capnocytophaga infection may cause blistering, oozing from the wound, fever and joint pain. ...
... Furthermore, in British Columbia, while C. gattii was identified in air samples more commonly during the warm, dry summer months, there was no association between the flowering or pollination times of individual tree species and the detected concentrations of airborne C. gattii [34]. It is also possible that other factors which impact on the incidence of infectious diseases in FNQ-including urban expansion, the impact of the local monsoonal wet season on vegetation growth and human activity-play a role in the temporospatial epidemiology of C. gattii in the region [35][36][37][38][39][40]. ...
Cryptococcal infections are an important cause of morbidity and mortality in tropical Austra-lia. This retrospective audit was conducted to characterise the aetiology, temporospatial epidemiology , and clinical course of 49 cryptococcal infections in Far North Queensland between 1 January 1999 and 31 December 2019. Cryptococcus gattii was identified in 15/ 32 (47%) in whom it was possible to speciate the organism. Among these 15 patients, 13 (87%) had a rural residential address, 10 (67%) were Indigenous Australians and 11 (73%) presented during the May-November dry season. When compared to the 17 patients with Cryptococcus neoformans infection, patients with C. gattii were less likely to be immuno-compromised (0/15 versus 8/17 (47%), p = 0.003). Neurosurgery was necessary in 5/15 C. gattii cases and 3/17 (18%) C. neoformans cases (p = 0.42). Outcomes were generally good with 42/49 (86%) cases-and 14/15 (93%) with C. gattii infection-surviving to hospital discharge. These positive outcomes are likely to be explained by the development of stan-dardised treatment guidelines during the study period, low rates of comorbidity in the patients with C. gattii infection and access to liposomal amphotericin and neurosurgical support in the well-resourced Australian healthcare system.
Introducción: Pasteurella multocida, es una bacteria cocobacilar Gram negativa, forma parte de la microbiota oral de animales con capacidad infectiva en los seres humanos se transmite mediante mordeduras de animales de compañía como caninos y felinos ocasionando infecciones leves en forma de celulitis a graves. Los datos epidemiológicos relacionados con estas infecciones son escasos, así nace la necesidad del presente reporte de caso clínico. Caso clínico: Paciente de 24 años de edad, acude a la casa de salud por molestias en la región metatarso falángica presentando edema, eritema y dolor con una sucesiva impotencia funcional, consecuencia de una mordedura ocasionada por un felino. Se le realiza una limpieza quirúrgica, radiografía y cultivo del líquido drenado del cual se aíslan colonias de Pasteurella multocida, estableciendo el tratamiento para la recuperación del paciente. Conclusión: El diagnóstico de infecciones por mordeduras de animales incluyen la participación médica con la clínica del paciente, personal de radiología y del microbiólogo en la identificación del agente causal. El trabajo en conjunto de las áreas permite el diagnóstico oportuno y abordaje de la sintomatología del paciente, llevando al éxito terapéutico.
Background:
There is a high burden of skin and soft tissue infections (SSTI) - including cellulitis - among Aboriginal and Torres Strait Islander peoples living in remote communities. In tropical environments, such as the Torres Strait, cellulitis accounts for 37% of potentially preventable hospitalisations. This study aimed to evaluate the safety, effectiveness and community acceptance of outpatient antibiotic treatment for the management of skin infections in the Torres Strait.
Methods:
This was a 12-month prospective, observational study commencing in January 2019 involving 295 adults with a skin infection across the Torres Strait.
Results:
Most (276/295 (94%)) participants were treated successfully in the community. Of 295 enrolled patients, 151 of 295 (51%) had cellulitis, 59 of 295 (20%) had a skin abscess and 85 of 295 (28%) had a wound infection. Of the 77 of 278 (27%) infections accompanied by systemic features, 63 of 77 (82%) were managed in the community. Staphylococcus aureus was the most frequent isolate, at 165 of 261 (63%); 56 of 165 (33%) were methicillin resistant. In the 276 community-managed cases, oral trimethoprim/sulfamethoxazole was initially used in 159 (57%), oral flucloxacillin in 75 (27%) and intravenous cefazolin plus oral probenecid in 32 (13%). The clinical course was complicated in eight of 232 (3%) patients who had complete follow-up data: seven patients required hospitalisation after initial treatment in the communityand one had an antibiotic side-effect. All 232 patients with complete follow-up data were content with the care they received.
Conclusions:
Outpatient management of skin infection in the Torres Strait is effective, safe and appreciated by patients.
An understanding of the seasonality of infections informs public health strategies and assists clinicians in their management of patients with undifferentiated illness. The seasonality of infections is driven by a variety of environmental and human factors; however, the role of individual climatic factors has garnered much attention. This study utilises Poisson regression models to assess the seasonality of six important infections in tropical Australia and their association with climatic factors and severe weather events over a 21-year period. Melioidosis and leptospirosis showed marked wet season predominance, while more cases of rickettsial disease and cryptococcosis were seen in cooler, drier months. Staphylococcus aureus infections were not seasonal, while influenza demonstrated inter-seasonality. The climate did not significantly change during the 21 years of the study period, but the incidence of melioidosis and rickettsial disease increased considerably, highlighting the primacy of other factors-including societal inequality, and the impact of urban expansion-in the incidence of these infections. While anthropogenic climate change poses a threat to the region-and may influence the burden of these infections in the future-this study highlights the fact that, even for seasonal diseases, other factors presently have a greater effect on disease incidence. Public health strategies must also target these broader drivers of infection if they are to be effective.
