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Hsu JY, Chiang SO, Yang CC, Mao YC. A Nationwide Study on the Risks of Complications and Healthcare Costs of Snakebite Envenomation in Taiwan. Am J Trop Med Hyg 2024; 111:205-215. [PMID: 38714189 PMCID: PMC11229656 DOI: 10.4269/ajtmh.24-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 03/04/2024] [Indexed: 05/09/2024] Open
Abstract
In Taiwan, six medically important venomous snakes, Trimeresurus stejnegeri stejnegeri, Protobothrops mucrosquamatus, Deinagkistrodon acutus, Daboia siamensis, Naja atra, and Bungarus multicinctus, are found. However, comprehensive research on the complications and associated healthcare costs of snakebite envenomation (SBE) is lacking. We retrospectively analyzed pertinent information from the Taiwan National Health Insurance Research Database dated January 2002 to December 2014. We investigated the risk factors for complications and their impact on healthcare costs. Among the 12,542 patients with SBE, those from N. atra or B. multicinctus were more likely to experience wound infections and neurological complications than were those from T. s. stejnegeri or P. mucrosquamatus. In addition, being female, being elderly, and having a Charlson Comorbidity Index equal to or greater than 3 points were associated with an increased likelihood of wound infections and psychological complications. The annual national economic burden averaged US$1,083,624, with an average healthcare cost of US$1,129 per SBE. Snakebite envenomations from N. atra or B. multicinctus, as well as various complications, resulted in significantly higher costs. It is crucial to comprehend the risk factors for complications and their role in increasing expenses to provide insight for tailored healthcare interventions, mitigate complications, and reduce the economic burdens associated with SBEs.
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Affiliation(s)
- Jen-Yu Hsu
- Department of Occupational Medicine and Clinical Toxicology, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Shu-O Chiang
- ESTAT Statistical Consulting Co., Ltd, Taipei, Taiwan
| | - Chen-Chang Yang
- Department of Occupational Medicine and Clinical Toxicology, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Environmental and Occupational Health Sciences, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yan-Chiao Mao
- PhD Program in Medical Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Division of Clinical Toxicology, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
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Renault A, Ng VERF, Goh WC, Hamid MNHA, Osman AMZ, Safferi RS, Mohamed Ismail Z, Ismail AK. Frequency, geographical distribution, clinical characteristics, antivenom utilisation and outcomes of King Cobra (Ophiophagus hannah) bites in Malaysia. PLoS Negl Trop Dis 2024; 18:e0012359. [PMID: 39052675 DOI: 10.1371/journal.pntd.0012359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 08/06/2024] [Accepted: 07/09/2024] [Indexed: 07/27/2024] Open
Abstract
Snakebite envenomation remains an important, yet a neglected public health issue in most tropical and subtropical countries. Underdeveloped medical infrastructure, suboptimal medical services, poor documentation and failure to make snake-related injury a mandatory notifiable disease are important contributing factors. The King Cobra (Ophiophagus hannah) is a medically significant species encountered in Malaysia however, there have been few publications from the clinical perspective. The objectives of this study were to determine the frequency of King Cobra related injuries, geographical distribution, clinical presentation, type and frequency of antivenom utilization and the management outcome. This is a cross-sectional study of confirmed King Cobra related injuries consulted to Remote Envenomation Consultation Services (RECS) from 2015 to 2020. Data were extracted from the RECS database and descriptively analyzed. A total of 32 cases of King Cobra bite were identified. Most cases were from Peninsular Malaysia with the most frequent from the state of Pahang (n = 9, 28.1%). Most patients got bitten while attempting to catch or play with the snake (68.8%). Signs and symptoms of envenomation were documented in 24 (75.0%) cases and the most frequent systemic manifestation was ptosis (n = 13, 40.6%). Tracheal intubation and ventilatory support were required in 13 (40.6%) patients. Antivenom was administered to 22 (68.8%) patients with most (25.0%) receiving 10 vials (1 dose). The commonest antivenom used was monospecific King Cobra antivenom (50.0%) from Thai Red Cross. There was one death documented due to complications from necrotizing fasciitis and septicemia. Public awareness of the dangers and proper handling of King Cobras needs to be emphasised. Timely administration of the appropriate antivenom is the definitive treatment and leads to favorable outcomes.
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Affiliation(s)
- Asyhok Renault
- Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Vera Effa Rezar Frederic Ng
- Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Wan Chee Goh
- Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | | | - Ruth Sabrina Safferi
- Emergency and Trauma Department, Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia
| | | | - Ahmad Khaldun Ismail
- Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia
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Larréché S, Bousquet A, da Silva L, Planelles A, Ksas R, Mérens A, Chippaux JP. Antibiotic susceptibility of cultivable microbiota from the oral cavity of captive Bothrops atrox and Bothrops lanceolatus: Implications for the treatment of snakebite-associated infections in the French departments of America. Infect Dis Now 2023; 53:104721. [PMID: 37196810 DOI: 10.1016/j.idnow.2023.104721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/11/2023] [Accepted: 05/07/2023] [Indexed: 05/19/2023]
Abstract
INTRODUCTION Secondary infection is a frequent complication after bites by Bothrops atroxin French Guiana or B. lanceolatus in Martinique. Knowledge of the bacteria present in snake mouths is a valuable aid for determining probabilistic antibiotherapy after Bothrops bite. The objectives of this study were to describe the cultivable bacteria of the oral microbiota of the specimens of B. atrox and B. lanceolatus kept in captivity, and to study their susceptibility to antibiotics. METHODS Fifteen B. atrox and 15 B. lanceolatus were sampled. Bacterial cultures were performed and each morphotype on plates was identified using MALDI-TOF mass spectrometry. Antibiotic susceptibility was studied using the agar disk diffusion method, with possible determination of the MICs. RESULTS One hundred and twenty-two isolates were identified: 52 isolates and 13 species in B. atrox, 70 isolates and 23 species in B. lanceolatus. The main species were Providencia rettgeri, Morganella morganii, Pseudomonas aeruginosa, Staphylococcus xylosus, and Paeniclostridium sordellii (only in B. lanceolatus mouths). For B. atrox, 96% of isolates were susceptible to piperacillin/tazobactam, cefepime, imipenem and meropenem, 94% to ciprofloxacin and 76% to cefotaxime and ceftriaxone. For B. lanceolatus, 97% of isolates were susceptible to meropenem, 96% to cefepime, 93% to imipenem and piperacillin/tazobactam, 80% to ciprofloxacin, and 75% to cefotaxime and ceftriaxone. Many isolates were resistant towards amoxicillin/clavulanate. CONCLUSION Among currently recommended antibiotics, cefepime and piperacillin/tazobactam seem more suitable than cefotaxime or ceftriaxone in the event of a Bothrops bite. Ciprofloxacin may also be considered for B. atrox.
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Affiliation(s)
- S Larréché
- Department of Medical Biology, Bégin Military Teaching Hospital, 69 avenue de Paris, 94160 Saint-Mandé, France; INSERM, UMRS-1144, Paris Cité University, 4 avenue de l'Observatoire, 75006 Paris, France.
| | - A Bousquet
- Department of Medical Biology, Bégin Military Teaching Hospital, 69 avenue de Paris, 94160 Saint-Mandé, France
| | - L da Silva
- Department of Medical Biology, Bégin Military Teaching Hospital, 69 avenue de Paris, 94160 Saint-Mandé, France
| | - A Planelles
- Venomworld, 28 rue Paul-Henri Spaak, 77400 Saint-Thibault-des-Vignes, France
| | - R Ksas
- Venomworld, 28 rue Paul-Henri Spaak, 77400 Saint-Thibault-des-Vignes, France
| | - A Mérens
- Department of Medical Biology, Bégin Military Teaching Hospital, 69 avenue de Paris, 94160 Saint-Mandé, France; French Military Medical Academy, 1 place Alphonse Laveran, 75005 Paris, France
| | - J-P Chippaux
- UMR216-MERIT, Paris Cité University, 4 avenue de l'Observatoire, 75006 Paris, France
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Yeh H, Gao SY, Lin CC. Wound Infection of Snakebite from Venomous Protobothrops mucrosquamatus, Viridovipera stejnegeri and Naja atra in Taiwan: Validation of BITE and Cobra BITE Scoring Systems and their Bacteriological Differences in Wound Cultures. Toxins (Basel) 2023; 15:78. [PMID: 36668897 PMCID: PMC9861491 DOI: 10.3390/toxins15010078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/08/2023] [Accepted: 01/10/2023] [Indexed: 01/17/2023] Open
Abstract
Patients bitten by Protobothrops mucrosquamatus, Viridovipera stejnegeri, and Naja atra develop different degrees of wound infection. This study validated BITE and Cobra BITE scoring systems that we established previously. Bacteriological studies of patients with wound infection were conducted. The operating characteristic curves and area under the curve (AUC) and wound infection rates were compared between the derivation set (our previous study patient population) and the validation set (new patient cohorts enrolled between June 2017 and May 2021). No significant differences in the AUC for both the BITE (0.84 vs. 0.78, p = 0.27) and Cobra BITE (0.88 vs. 0.75, p = 0.21) scoring systems were observed between the derivation and validation sets. Morganella morganii and Enterococcus faecalis were the two most commonly detected bacteria in the microbiological study. More bacterial species were cultured from N. atra-infected wounds. Antibiotics such as amoxicillin with clavulanic acid, oxacillin, and ampicillin may not be suitable for treating patients with P. mucrosquamatus, V. stejnegeri, and N. atra bites in Taiwan. Carbapenem, third-generation cephalosporins, and fluoroquinolone may be superior alternatives.
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Affiliation(s)
- Heng Yeh
- Department of Emergency Medicine, Lin-Kou Medical Center, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Shi-Ying Gao
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Chih-Chuan Lin
- Department of Emergency Medicine, Lin-Kou Medical Center, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
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Bhaumik S, Gopalakrishnan M, Kirubakaran R, Jagnoor J. Antibiotics for preventing wound infections after snakebite. Hippokratia 2022. [DOI: 10.1002/14651858.cd015114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Soumyadeep Bhaumik
- The George Institute for Global Health, Faculty of Medicine; University of New South Wales; Sydney Australia
- Meta-research and Evidence Synthesis Unit; The George Institute for Global Health; New Delhi India
| | - Maya Gopalakrishnan
- Department of Internal Medicine; All India Institute of Medical Sciences, Jodhpur; Jodhpur India
| | - Richard Kirubakaran
- Cochrane India-CMC Vellore Affiliate, Prof. BV Moses Centre for Evidence Informed Healthcare and Health Policy; Christian Medical College; Vellore India
| | - Jagnoor Jagnoor
- The George Institute for Global Health, Faculty of Medicine; University of New South Wales; Sydney Australia
- Injury Division; The George Institute for Global Health; New Delhi India
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Esmaeilishirazifard E, Usher L, Trim C, Denise H, Sangal V, Tyson GH, Barlow A, Redway KF, Taylor JD, Kremyda-Vlachou M, Davies S, Loftus TD, Lock MMG, Wright K, Dalby A, Snyder LAS, Wuster W, Trim S, Moschos SA. Bacterial Adaptation to Venom in Snakes and Arachnida. Microbiol Spectr 2022; 10:e0240821. [PMID: 35604233 PMCID: PMC9248900 DOI: 10.1128/spectrum.02408-21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/14/2022] [Indexed: 11/20/2022] Open
Abstract
Animal venoms are considered sterile sources of antimicrobial compounds with strong membrane-disrupting activity against multidrug-resistant bacteria. However, venomous bite wound infections are common in developing nations. Investigating the envenomation organ and venom microbiota of five snake and two spider species, we observed venom community structures that depend on the host venomous animal species and evidenced recovery of viable microorganisms from black-necked spitting cobra (Naja nigricollis) and Indian ornamental tarantula (Poecilotheria regalis) venoms. Among the bacterial isolates recovered from N. nigricollis, we identified two venom-resistant, novel sequence types of Enterococcus faecalis whose genomes feature 16 virulence genes, indicating infectious potential, and 45 additional genes, nearly half of which improve bacterial membrane integrity. Our findings challenge the dogma of venom sterility and indicate an increased primary infection risk in the clinical management of venomous animal bite wounds. IMPORTANCE Notwithstanding their 3 to 5% mortality, the 2.7 million envenomation-related injuries occurring annually-predominantly across Africa, Asia, and Latin America-are also major causes of morbidity. Venom toxin-damaged tissue will develop infections in some 75% of envenomation victims, with E. faecalis being a common culprit of disease; however, such infections are generally considered to be independent of envenomation. Here, we provide evidence on venom microbiota across snakes and arachnida and report on the convergent evolution mechanisms that can facilitate adaptation to black-necked cobra venom in two independent E. faecalis strains, easily misidentified by biochemical diagnostics. Therefore, since inoculation with viable and virulence gene-harboring bacteria can occur during envenomation, acute infection risk management following envenomation is warranted, particularly for immunocompromised and malnourished victims in resource-limited settings. These results shed light on how bacteria evolve for survival in one of the most extreme environments on Earth and how venomous bites must be also treated for infections.
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Affiliation(s)
- Elham Esmaeilishirazifard
- Department of Biomedical Sciences, Faculty of Science and Technology, University of Westminster, London, United Kingdom
- Westminster Genomic Services, Faculty of Science and Technology, University of Westminster, London, United Kingdom
| | - Louise Usher
- Department of Biomedical Sciences, Faculty of Science and Technology, University of Westminster, London, United Kingdom
- Westminster Genomic Services, Faculty of Science and Technology, University of Westminster, London, United Kingdom
| | - Carol Trim
- School of Psychology and Life Sciences, Faculty of Science, Engineering and Social Sciences, Canterbury Christ Church University, Canterbury, Kent, United Kingdom
| | - Hubert Denise
- EMBL-EBI European Bioinformatics Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, United Kingdom
| | - Vartul Sangal
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle, Tyne and Wear, United Kingdom
| | - Gregory H. Tyson
- Food and Drug Administration, Center for Veterinary Medicine, Office of Research, Laurel, Maryland, USA
| | - Axel Barlow
- Institute for Biochemistry and Biology, University of Potsdam, Potsdam, Germany
| | - Keith F. Redway
- Department of Biomedical Sciences, Faculty of Science and Technology, University of Westminster, London, United Kingdom
| | - John D. Taylor
- Department of Biomedical Sciences, Faculty of Science and Technology, University of Westminster, London, United Kingdom
- Westminster Genomic Services, Faculty of Science and Technology, University of Westminster, London, United Kingdom
- School of Environment and Life Sciences, University of Salford, Salford, Greater Manchester, United Kingdom
| | - Myrto Kremyda-Vlachou
- Department of Biomedical Sciences, Faculty of Science and Technology, University of Westminster, London, United Kingdom
| | - Sam Davies
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle, Tyne and Wear, United Kingdom
| | | | | | - Kstir Wright
- Department of Biomedical Sciences, Faculty of Science and Technology, University of Westminster, London, United Kingdom
| | - Andrew Dalby
- Department of Biomedical Sciences, Faculty of Science and Technology, University of Westminster, London, United Kingdom
| | - Lori A. S. Snyder
- School of Life Sciences, Pharmacy, and Chemistry, Kingston University, London, United Kingdom
| | - Wolfgang Wuster
- Molecular Ecology and Evolution at Bangor, School of Biological Sciences, College of Natural Sciences, Bangor University, Bangor, Wales, United Kingdom
| | - Steve Trim
- Venomtech, Ltd., Sandwich, Kent, United Kingdom
| | - Sterghios A. Moschos
- Department of Biomedical Sciences, Faculty of Science and Technology, University of Westminster, London, United Kingdom
- Westminster Genomic Services, Faculty of Science and Technology, University of Westminster, London, United Kingdom
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle, Tyne and Wear, United Kingdom
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Chuang PC, Lin WH, Chen YC, Chien CC, Chiu IM, Tsai TS. Oral Bacteria and Their Antibiotic Susceptibilities in Taiwanese Venomous Snakes. Microorganisms 2022; 10:microorganisms10050951. [PMID: 35630396 PMCID: PMC9147925 DOI: 10.3390/microorganisms10050951] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/15/2022] [Accepted: 04/28/2022] [Indexed: 12/07/2022] Open
Abstract
Wound infections after venomous snakebites are clinically important. Information regarding the nature and antibiotic susceptibilities of snake oral bacterial flora could support empiric antibiotic therapy. Wild venomous snakes were collected from southern Taiwan: a total of 30 each of Bungarus multicinctus, Naja atra, Protobothrops mucrosquamatus, and Trimeresurus stejnegeri; 3 Deinagkistrodon acutus; and 4 Daboia siamensis. The species and antibiotic susceptibilities of their oral bacteria were determined. Aerobic gram-negative bacteria, especially Pseudomonas aeruginosa and Proteus vulgaris, were the most abundant. Proteus vulgaris were more abundant in B. multicinctus, N. atra, and P. mucrosquamatus than in T. stejnegeri (40%, 43.3%, and 40% vs. 13.3%, respectively). The gram-negative species were less susceptible to first- and second-generation cephalosporins and ampicillin-sulbactam than to third-generation cephalosporins, fluoroquinolones, carbapenems, or piperacillin-tazobactam. The most abundant aerobic gram-positive species cultured was Enterococcus faecalis, which was more abundant in N. atra than in other snakes (p < 0.001) and was highly susceptible to ampicillin, high-level gentamicin, penicillin, teicoplanin, and vancomycin. Bacteroides fragilis and Clostridium species were the most common anaerobic bacteria. The anaerobic organisms were highly susceptible to metronidazole and piperacillin. As a reference for empiric antimicrobial therapy, third-generation cephalosporins, fluoroquinolones, carbapenems, or piperacillin-tazobactam can be initiated in venomous snakebites wound infections.
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Affiliation(s)
- Po-Chun Chuang
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan; (P.-C.C.); (I.-M.C.)
- College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan
| | - Wen-Hao Lin
- Institute of Wildlife Conservation, National Pingtung University of Science and Technology, Pingtung 912301, Taiwan;
| | - Yi-Chun Chen
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan;
| | - Chun-Chih Chien
- College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan
- Department of Laboratory Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan;
| | - I-Min Chiu
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan; (P.-C.C.); (I.-M.C.)
- College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan
| | - Tein-Shun Tsai
- Department of Biological Science and Technology, National Pingtung University of Science and Technology, Pingtung 912301, Taiwan
- Correspondence: or
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Silva C, Requicha JF, Martins JJ, Duarte A, Dias IR, Viegas CA, Saavedra MJ. Black-and-White Ruffed Lemur ( Varecia variegata) in Captivity: Analysis of the Oral Microbiota in a One Health Perspective. Animals (Basel) 2021; 11:2905. [PMID: 34679926 PMCID: PMC8533010 DOI: 10.3390/ani11102905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/24/2021] [Accepted: 09/29/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed to characterize the susceptibility profile to antibiotics and biofilm formation of Gram-negative bacterial isolates obtained from the oral cavity of the black-and-white ruffed lemur (Varecia variegata). From eight individuals from a zoo located in Portugal, samples of the oral microbiota were collected with sterile swabs and then placed in closed tubes with a transport medium. Culture was carried out for media of Gram-negative bacteria. Twenty-two isolates were obtained and subjected to susceptibility tests to twenty-five antimicrobial agents belonging to seven different classes. All tested isolates demonstrated resistance to, at least, one antibiotic, and it was possible to observe multidrug resistance in 11 of the 22 isolates (50%). It should be noted that an isolate showed phenotypic resistance to imipenem, an antibiotic for exclusive use in a hospital environment. All the isolates showed an increasing ability of biofilm formation over time. The obtained results show that wild mammals in captivity could be reservoirs and potential sources of multi-resistant pathogens. In view of this fact and considering the One Health concept, it will be advisable to establish local monitoring programs worldwide that benefit and protect human, animal and environmental health.
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Affiliation(s)
- Carolina Silva
- Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal; (C.S.); (J.F.R.); (I.R.D.); (C.A.V.)
| | - João F. Requicha
- Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal; (C.S.); (J.F.R.); (I.R.D.); (C.A.V.)
- Animal and Veterinary Research Center (CECAV) and AL4AnimalS, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal;
| | - José J. Martins
- Animal and Veterinary Research Center (CECAV) and AL4AnimalS, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal;
- Department of Animal Science, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
- Interdisciplinary Centre of Marine and Environmental Research (CIIMAR), Terminal de Cruzeiros do Porto de Leixões, 4450-208 Matosinhos, Portugal
| | - Aida Duarte
- Department of Microbiology and Immunology, Faculty of Pharmacy and Research, University of Lisbon, 1640-042 Lisbon, Portugal;
- Center of Egas Moniz (CiiEM), 2825-001 Monte da Caparica, Portugal
| | - Isabel R. Dias
- Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal; (C.S.); (J.F.R.); (I.R.D.); (C.A.V.)
- Animal and Veterinary Research Center (CECAV) and AL4AnimalS, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal;
- Center for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB) and Inov4Agro, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
| | - Carlos A. Viegas
- Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal; (C.S.); (J.F.R.); (I.R.D.); (C.A.V.)
- Animal and Veterinary Research Center (CECAV) and AL4AnimalS, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal;
- Center for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB) and Inov4Agro, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
| | - Maria J. Saavedra
- Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal; (C.S.); (J.F.R.); (I.R.D.); (C.A.V.)
- Animal and Veterinary Research Center (CECAV) and AL4AnimalS, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal;
- Interdisciplinary Centre of Marine and Environmental Research (CIIMAR), Terminal de Cruzeiros do Porto de Leixões, 4450-208 Matosinhos, Portugal
- Center for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB) and Inov4Agro, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
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Unveiling the Potential Threat of Bacterial Oral Flora of Snake in Snake Bite Envenomation. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2021. [DOI: 10.1097/ipc.0000000000000948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Padhi L, Panda SK, Mohapatra PP, Sahoo G. Antibiotic susceptibility of cultivable aerobic microbiota from the oral cavity of Echis carinatus from Odisha (India). Microb Pathog 2020; 143:104121. [PMID: 32169497 DOI: 10.1016/j.micpath.2020.104121] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 03/03/2020] [Accepted: 03/06/2020] [Indexed: 11/27/2022]
Abstract
During a snake bite, the microbes may get transferred to the bite site and may cause secondary infection along with envenomation. The knowledge on the oral bacterial flora of snakes constitutes information important for snake bite management. The inadequately studied oral microflora of snakes differ geographically, temporally and among the members of the same species. The objective of this study is to determine the pattern of oral bacterial flora of Saw-scaled viper (Echis carinatus) and their susceptibility to antibiotics. Oral swabs were collected from nine healthy Saw-scaled vipers, subjected to microbiological, biochemical and molecular characterization. Additionally, these isolates were subjected to antimicrobial susceptibility testing using ICOSA-20-Plus and ICOSA-20-Minus. A wide range of pathogenic bacteria such as Salmonella arizonae, Pseudomonas stutzeri, Proteus penneri, Alcaligenes faecalis; Citrobacter diversus, C. freundii, Enterococcus faecalis, Bacillus anthracis, Staphylococcus sciuri and Achromobacter xylosoxidans were isolated as new additions to the floral diversity of saw scale viper. Most of the isolates were sensitive towards amikacin, azithromycin, imipenem, ciprofloxacin, gentamicin, ofloxacin, sparfloxacin, tobramycin, levofloxacin, kanamycin, tetracycline, and chloramphenicol while resistant to amoxyclav, cephalothin, cefpodoxime, Co-Trimoxazole, oxacillin and penicillin. The present study revealed that the bacterial flora of the oral cavity of Saw-scaled viper is resistant to many common antibiotics, which are often used for the treatment of snake-bite victims.
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Affiliation(s)
- Laxmipriya Padhi
- Department of Zoology, North Orissa University, Baripada, 757003, Odisha, India
| | - Sujogya Kumar Panda
- Department of Zoology, North Orissa University, Baripada, 757003, Odisha, India
| | - Pratyush P Mohapatra
- Central Zone Regional Centre, Zoological Survey of India, Jabalpur, Madhya Pradesh, India
| | - Gunanidhi Sahoo
- Department of Zoology, Utkal University, Bhubaneswar, 751004, Odisha, India.
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A Brief Review on Biting/Stinging of Animals and Its Risk of Infection. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2020. [DOI: 10.5812/archcid.97499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Panda SK, Padhi L, Sahoo G. Evaluation of cultivable aerobic bacterial flora from Russell's viper (Daboia russelii) oral cavity. Microb Pathog 2019; 134:103573. [PMID: 31163249 DOI: 10.1016/j.micpath.2019.103573] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 04/04/2019] [Accepted: 05/31/2019] [Indexed: 10/26/2022]
Abstract
Snake mouths contain a wide range of bacteria. Identifying these bacteria in snakes is very important to obtain an understanding of the etiological agents of secondary infections that may result from accidents during handling and/or snake bites. The present study aims to determine the pattern of oral bacterial flora of nine healthy Russell's vipers (Daboia russelii), and their susceptibility to common antibiotics. A total of 94 isolates were obtained in pure form, which demonstrated noticeable colony characteristics and which were further studied with several biochemical tests. The strains that showed distinctive colonies, morphology and biochemical parameters were additionally subjected to phylogenetic characterization using 16S rRNA gene sequences. Furthermore, all these isolates were studied for antibiotic susceptibility. The oral cavity of the Russell's viper harbors a wide range of pathogenic bacteria, including Gram-negative genera: Proteus sp., Pseudomonas sp., Salmonella sp., Providencia sp., Alcaligenes sp., Morganella sp., as well as E. coli, and Gram-positive genera: Bacillus and Enterococcus sp., Staphylococcus sp. and Lysinobacillus sp. Most of the isolates were resistant to antibiotics viz. penicillin, Amoxyclav, oxacillin, methicillin and streptomycin while sensitive towards imipenem, amikacin, norfloxacin, gatifloxacin, ciprofloxacin, gentamicin, tetracycline, chloramphenicol and azithromycin. The present study documents diverse bacteria predominant in the oral cavity of Daboia russelii and studied their antibiotic susceptibilities.
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Affiliation(s)
- Sujogya Kumar Panda
- Department of Zoology, North Orissa University, Baripada, 757003, Odisha, India
| | - Laxmipriya Padhi
- Department of Zoology, North Orissa University, Baripada, 757003, Odisha, India
| | - Gunanidhi Sahoo
- Department of Zoology, Utkal University, Bhubaneswar, 751004, Odisha, India.
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Williams HF, Layfield HJ, Vallance T, Patel K, Bicknell AB, Trim SA, Vaiyapuri S. The Urgent Need to Develop Novel Strategies for the Diagnosis and Treatment of Snakebites. Toxins (Basel) 2019; 11:E363. [PMID: 31226842 PMCID: PMC6628419 DOI: 10.3390/toxins11060363] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 06/18/2019] [Accepted: 06/18/2019] [Indexed: 01/09/2023] Open
Abstract
Snakebite envenoming (SBE) is a priority neglected tropical disease, which kills in excess of 100,000 people per year. Additionally, many millions of survivors also suffer through disabilities and long-term health consequences. The only treatment for SBE, antivenom, has a number of major associated problems, not least, adverse reactions and limited availability. This emphasises the necessity for urgent improvements to the management of this disease. Administration of antivenom is too frequently based on symptomatology, which results in wasting crucial time. The majority of SBE-affected regions rely on broad-spectrum polyvalent antivenoms that have a low content of case-specific efficacious immunoglobulins. Research into small molecular therapeutics such as varespladib/methyl-varespladib (PLA2 inhibitors) and batimastat/marimastat (metalloprotease inhibitors) suggest that such adjunctive treatments could be hugely beneficial to victims. Progress into toxin-specific monoclonal antibodies as well as alternative binding scaffolds such as aptamers hold much promise for future treatment strategies. SBE is not implicit during snakebite, due to venom metering. Thus, the delay between bite and symptom presentation is critical and when symptoms appear it may often already be too late to effectively treat SBE. The development of reliable diagnostical tools could therefore initiate a paradigm shift in the treatment of SBE. While the complete eradication of SBE is an impossibility, mitigation is in the pipeline, with new treatments and diagnostics rapidly emerging. Here we critically review the urgent necessity for the development of diagnostic tools and improved therapeutics to mitigate the deaths and disabilities caused by SBE.
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Affiliation(s)
| | | | - Thomas Vallance
- School of Pharmacy, University of Reading, Reading RG6 6AH, UK.
| | - Ketan Patel
- School of Biological Sciences, University of Reading, Reading RG6 6AH, UK.
| | - Andrew B Bicknell
- School of Biological Sciences, University of Reading, Reading RG6 6AH, UK.
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