ABSTRACT
INTRODUCTION: Patients and physicians often underestimate cat bite injuries. The deep and narrow wound seals quickly and provides an environment for the inoculated saliva and bacteria. Interestingly, the literature reports no bacterial growth in the microbiological workup of wound swaps in up to 43%. The time between bite injury and the first clinical presentation, the start of antibiotic treatment and surgical debridement might affect these findings. Therefore, the current project examines if (1) these factors impact the outcome of microbiological results following cat bite injuries and (2) the detection of bacterial growth leads to higher complication rates, longer hospital stays, longer total treatment time, or higher total treatment costs. MATERIALS AND METHODS: This single-center retrospective study analyzed data from 102 adult patients. All patients received antibiotic and surgical treatment following a cat bite injury. Microbiological samples were collected during surgery in all cases. The time from the bite incident to the first presentation, beginning of antibiotic administration, and surgical debridement was calculated. Demographic data, complication rate, length of hospital stay, total treatment time, and total treatment costs were recorded. (1) A generalized linear model was fitted using the microbiological outcome as the dependent variable. (2) Two groups (negative or positive microbiological results) were formed and statistically compared. RESULTS: The median age was 50 (SD 16), and 72% were female. (1) The time from the bite incident to the first clinical presentation, antibiotic administration, or surgical treatment was not associated with the outcome of the microbiological result. (2) No significant differences were observed between the two groups. CONCLUSIONS: Our data do not suggest that early antibiotic administration or delayed surgical treatment affects the outcome of the microbiological workup following cat bite injuries to the hand and forearm. The microbiological outcome did not affect the complication rate, treatment time, and total treatment costs.
Subject(s)
Anti-Bacterial Agents , Bites and Stings , Hand Injuries , Bites and Stings/complications , Bites and Stings/microbiology , Bites and Stings/surgery , Female , Animals , Humans , Male , Cats , Retrospective Studies , Middle Aged , Anti-Bacterial Agents/therapeutic use , Adult , Hand Injuries/surgery , Hand Injuries/microbiology , Debridement , Forearm Injuries/surgery , Treatment Outcome , Aged , Length of Stay/statistics & numerical dataABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Phaeohyphomycosis/drug therapy , Phaeohyphomycosis/microbiology , Erythema/diagnosis , Hand Injuries/diagnosis , Alternaria/isolation & purification , Biopsy , Blood Culture , Antifungal Agents/therapeutic use , Erythema/etiology , Erythema/microbiology , Phaeohyphomycosis/pathology , Hand Injuries/microbiology , Hand Injuries/pathologyABSTRACT
Empirical antibiotic treatment for hand infections is changing to single antibiotic therapy against Staphylococcus aureus in immunocompetent patients. Fifty-one patients treated surgically for hand infections were reviewed to assess the nature of infection in terms of site, organism, mechanism of injury, and antibiotic sensitivity of the organisms. Twenty-three per cent of patients had diabetes mellitus and were noted to be older than non-diabetics. Eighty-four per cent of non-diabetic patients had single organism infections, 59 involving S aureus. Fifty per cent of diabetic patients had multi-organism infection caused by gram positive and gram negative organisms. Patients stuck with a piece of wood also had multi-organism infections. Double antibiotic therapy is therefore advocated for patients with diabetes mellitus and all patients who had hand infections as a result of being stuck with a piece of wood. All others should have single antibiotic therapy with amoxycillin and clavulanic acid.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Diabetes Mellitus , Drug Therapy, Combination , Bacterial Infections/drug therapy , Hand Injuries/microbiology , Staphylococcus aureus , Aged, 80 and over , Microbial Sensitivity Tests , Retrospective Studies , Jamaica , Klebsiella , Anti-Bacterial Agents/therapeutic use , Bacterial Infections/etiology , Hand Injuries/complications , Hand Injuries/surgeryABSTRACT
Empirical antibiotic treatment for hand infections is changing to single antibiotic therapy against Staphylococcus aureus in immunocompetent patients. Fifty-one patients treated surgically for hand infections were reviewed to assess the nature of infection in terms of site, organism, mechanism of injury, and antibiotic sensitivity of organisms. Twenty-three percent of patients had diabetes mellitus and were noted to be older than non-diabetics. Eighty-four percent of non-diabetic patients had single organism infections, 59 percent involving S aureus. Fifty percent of diabetic patients had multi-organism infection caused by gram positive and gram negative organisms. Patients stuck with a piece of wood also had multi-organism infections. Double antiobiotic therapy is therefore advocated for patients with diabetes mellitus and all patients who had hand infections as a result of being stuck with a piece of wood. All others should have single antibiotic therapy with amoxycillin and clavulanic acid. (AU)