A cross-sectional survey of snake oral bacterial flora from Hong Kong, SAR, China.
OBJECTIVE
To determine the pattern of oral bacterial flora and their sensitivity to antibiotics in freshly captured native snakes in Hong Kong SAR, People's Republic of China.


METHODS
Healthy native snakes were captured and kept in a designated centre. Snake species were identified by experienced herpetologists. Mouth swabs were taken by the veterinarian using strict aseptic techniques. The snakes were released back to the wild immediately after the above procedure. Swabs were sent for microbiological studies of bacterial culture and antibiotic sensitivity.


RESULTS
47 venomous snakes of the families Colubridae, Elapidae and Viperidae and 53 non-medically important snakes were captured. 406 bacterial isolates of 72 different species were cultured: these included gram negative and positive bacterial species and also anaerobic bacterial species. With the exception of the white-lipped pit viper (Cryptelytrops albolabris), venomous snakes harboured more pathogenic bacteria and total bacteria species compared to the non-medically important species. Of the venomous snakes, the Chinese cobra (Naja atra) harboured the largest number of bacterial species. In the present study, all gram negative bacteria associated with wound infection were sensitive to levofloxacin, netilmicin and piperacillin/tazobactam. Many gram negative bacteria in the study were not sensitive to cefuroxime axetil. Amoxicillin/clavulanic acid was an appropriate choice to cover Enterococcus faecalis and anaerobes.


CONCLUSIONS
In the presence of wound infection from snakebite injury in Hong Kong, first line empirical antibiotics include amoxicillin/clavulanic acid plus levofloxacin. Prophylactic antibiotics may be considered in selected cases of Chinese cobra (N. atra) bite, otherwise prophylactic antibiotics are not recommended in snakebite unless tissue necrosis is present.
Department of Accident and Emergency, Pok Oi Hospital, Au Tau, New Territories, Hong Kong SAR, People's Republic of China. lamkk01@yahoo.com
Ka Keung
KK
Lam
Paul
P
Crow
Kenneth Ho Leung
KH
Ng
Kam Chuen
KC
Shek
Hin Tat
HT
Fung
Gary
G
Ades
Alessandro
A
Grioni
Kit Sun
KS
Tan
Kam Tong
KT
Yip
David Christopher
DC
Lung
Tak Lun
TL
Que
Tommy Shing Kit
TS
Lam
Ian D
ID
Simpson
Kwok Leung
KL
Tsui
Chak Wah
CW
Kam
D000818:Animals; D001419:Bacteria / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D003430:Cross-Sectional Studies; D024881:Drug Resistance, Bacterial; D006723:Hong Kong; D006801:Humans; D008826:Microbial Sensitivity Tests; D009055:Mouth / Q000382:microbiology*; D012909:Snake Bites / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D012911:Snakes / Q000382:microbiology*; D014946:Wound Infection / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology