Clinical presentation and bacteriologic analysis of infected human bites in patients presenting to emergency departments.
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.
Talan
David A
DA
Division of Emergency Medicine, Department of Medicine, Olive View-University of California at Los Angeles Medical Center, Sylmar, California 91342, USA. idnet@ucla.edu
Abrahamian
Fredrick M
FM
Moran
Gregory J
GJ
Citron
Diane M
DM
Tan
Jonah O
JO
Goldstein
Ellie J C
EJ
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*
D000900:Anti-Bacterial Agents