title: Clinical presentation and bacteriologic analysis of infected human bites in patients presenting to emergency departments.
abstract: Previous studies of infected human bites have been limited by small numbers of patients and suboptimal microbiologic methodology. We conducted a multicenter prospective study of 50 patients with infected human bites. Seventy percent of the patients and assailants were young adult men. Fifty-six percent of injuries were clenched-fist injuries and 44% were occlusional bites. Most injuries were to the hands. Fifty-four percent of patients were hospitalized. The median number of isolates per wound culture was 4 (3 aerobes and 1 anaerobe); aerobes and anaerobes were isolated from 54% of wounds, aerobes alone were isolated from 44%, and anaerobes alone were isolated from 2%. Isolates included Streptococcus anginosus (52%), Staphylococcus aureus (30%), Eikenella corrodens (30%), Fusobacterium nucleatum (32%), and Prevotella melaninogenica (22%). Candida species were found in 8%. Fusobacterium, Peptostreptococcus, and Candida species were isolated more frequently from occlusional bites than from clenched-fist injuries. Many strains of Prevotella and S. aureus were beta-lactamase producers. Amoxicillin-clavulanic acid and moxifloxacin demonstrated excellent in vitro activity against common isolates.
authors: Division of Emergency Medicine, Department of Medicine, Olive View-University of California at Los Angeles Medical Center, Sylmar, California 91342, USA. idnet@ucla.edu
authors: David A
authors: DA
authors: Talan
authors: Fredrick M
authors: FM
authors: Abrahamian
authors: Gregory J
authors: GJ
authors: Moran
authors: Diane M
authors: DM
authors: Citron
authors: Jonah O
authors: JO
authors: Tan
authors: Ellie J C
authors: EJ
authors: Goldstein
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001420:Bacteria, Aerobic / Q000302:isolation & purification; D001421:Bacteria, Anaerobic / Q000302:isolation & purification; D001424:Bacterial Infections / Q000188:drug therapy; D001734:Bites, Human / Q000188:drug therapy / Q000382:microbiology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014946:Wound Infection / Q000188:drug therapy / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents