The bacteriology of dog bite wounds on initial presentation

doi:10.1016/S0196-0644(86)80620-5

Annals of Emergency Medicine

Volume 15, Issue 11, November 1986, Pages 1324-1329

https://doi.org/10.1016/S0196-0644(86)80620-5 Get rights and content

Four hundred twenty patients with open dog bite wounds on initial presentation to the emergency department had Gram stains, aerobic and anerobic cultures, and antibiotic sensitivities of the bacterial isolates of each wound. Forty-eight percent of the wounds evidenced no bacterial growth. Staphylococcus epidermidis was the most common isolate (20.5%). Multiple bacteria were isolated in 15.5% of patients. Fifty percent of clinically infected wounds showed multiple pathogenic organisms, on both culture and Gram stain. The predominant pathogenic bacteria in clinically infected wounds were, in order, Enterobacteria, Pseudomonas, Staphyloccus aureus, Bacillus subtilis, and beta-Streptococcus. Gram stains were useful in determining specific antibiotic therapy in only 6% of infected cases and in 2% of uninfected cases. Statistical differences appeared between initially clinically infected and uninfected dog bite wounds, in both the types of bacteria and frequency of occurrence. Clinical infections were treated effectively with cephradine in more than 95% of cases. Infected wounds growing multiple pathogenic bacteria and/or Gram stains that showed multiple bacterial types were covered by a cephalosporin or penicillinase-resistant penicillin. Six percent of isolates could require an aminoglycoside for treatment.

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Cited by (25)

Bite wound infections
2013, Clinical Pediatric Emergency Medicine
Citation Excerpt :
Culture and Gram stain of fresh wounds are not warranted. Although a variety of organisms may be visualized on Gram stain or isolated in culture, the results of these studies have not been found to be predictive of the risk of subsequent infection or the organisms involved in such infections.27,28 For wounds with evidence of infection, culture of material obtained by swabbing or aspiration of the wound should be sent for aerobic and anaerobic culture, particularly in the case of exotic animal bites where data regarding the most common organisms are sparse.
Animal bites are a frequent reason for visits to the emergency department. Bite injuries are particularly important in pediatrics as more than half of victims are children. Although most bite wounds heal uneventfully, infectious complications are common. Emergency physicians should be familiar with the approach to the assessment and management of bite wounds and the treatment of infections that may occur. This article will review the epidemiology, management, and prevention of animal bite infections, including those from humans, dogs, cats, and other vertebrates.
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Although dog-to-dog bite wounds are frequent, few studies correlate bacterial involvement to clinical aspects. This work aimed at relating clinical evolution and bacteriological data, with the evolution time (ET), i.e., the period of time elapsed from aggression until presentation. A total of 228 wounds from 83 cases of bitten dogs was evaluated; 48 of the wounds were sampled for bacteriology. Dogs with clinically infected wounds (N = 29) were subjected to antimicrobial therapy and local disinfection. Dogs without clinical signs of infection were either subjected to the same treatment (N = 43) or only subjected to daily wound saline irrigation (N = 11), to evaluate the need for antimicrobial prophylaxis.
The majority of wounds were laceration and puncture wounds with dermis penetration (41.2% and 23.2%, respectively). Only 17% of the wounds were clinically infected. The mean ET was 39 h 30 m and prolonged ET was significantly correlated to infection. None of the wounds from animals not given antibiotics became infected. Bacteriology was positive in 95.8% of the wounds sampled (N = 46). A total of 125 isolates was obtained, mostly aerobes. Clinical infection was associated with the presence of strict anaerobes. Excluding antibiotics that should be preserved for life-threatening cases, the higher rates of in vitro antimicrobial susceptibility were observed for sulphamethoxazole–trimethoprim (94.4%) and amoxicillin–clavulanate (91.9%).
This study identified the time lag from aggression to presentation as a risk factor for infection development. Further studies are required to evaluate the actual requirement for antimicrobial therapy when only dermis is affected in dog-to-dog bite wounds.
Antimicrobial Prophylaxis for Wounds and Procedures in the Emergency Department
2008, Infectious Disease Clinics of North America
Citation Excerpt :
Infections are more common in the very young, elderly, and the immunocompromised. Cultures of the uninfected bite wound do not predict which patients will become infected nor do they reveal the subsequently identified pathogens in those who do [68,69]. Proper wound management is critical in preventing infection of bite wounds (and other highly contaminated wounds).
Emergency physicians are often confronted with situations in which a patient with an acute injury is at high risk for an infection. Although most traumatic wounds have a low risk for developing infection, certain types of high-risk trauma justify antimicrobial prophylaxis. This article reviews antimicrobial wound infection prophylaxis for high-risk traumatic wounds, including the prevention of rabies and tetanus. Prophylaxis to prevent infections related to invasive procedures in the emergency department is also addressed.
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Original contributionThe bacteriology of dog bite wounds on initial presentation

Ann Emerg Med

JACEP

Ann Emerg Med

Aerobic bacterial flora of oral and nasal fluids of canines with reference to bacteria associated with bites

J Clin Microbiol

Management of dog bite wounds

JAMA

Original contribution
The bacteriology of dog bite wounds on initial presentation