Biting off more than you can chew : microbiological flora isolated from human and animal bite wounds

Abstract

BACKGROUND: Bite wounds, from human and animal origin, can lead to significant complications if appropriate therapy is not undertaken timeously. A basic knowledge of the microbiological flora is essential for each clinical setting in order to be able to facilitate appropriate empiric antibiotic therapy. MATERIAL AND METHODS: All patients admitted to the Steve Biko Academic Hospital over a 27-month period with histories of bite wound and taken to theatre for debridement were included in this study. All culture data was collected together with sensitivity profiles for all organisms isolated. RESULTS: In total, 38 patients were included in this study, with 25 sustaining human bite wounds, 11 sustaining dog bites, and only two with snake bites. The most striking finding is the predominance of Streptococcus spp isolated from human bite wounds. Although a relatively rare finding, Salmonella spp was isolated from one of the patients who sustained a snake bite. A surprising fraction of isolates were resistant to Amox-Clav, with only marginally improved sensitivity rates to second generation cephalosporins and fluoroquinolones. CONCLUSIONS: This study emphasises the importance of obtaining microbiological cultures on all patients admitted with bite wounds. This will not only assist in surveillance practices, but also provides the clinician with targeted therapy if the empiric antimicrobial should fail.