Snakebite-Associated Infections: A Systematic Review and Meta-Analysis.

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Public Health

Background:

• Snakebites are a significant global health issue, particularly in developing nations, often leading to severe complications like infections.
• The World Health Organization (WHO) classifies snakebites as a neglected tropical condition due to their substantial morbidity and mortality rates.

Approach:

• A systematic literature review was conducted across five databases to determine the prevalence of snakebite infections.
• A meta-analysis using a random-effects model calculated the pooled prevalence and assessed heterogeneity among studies.
• Surgical intervention rates and common bacterial pathogens were characterized.

Key Points:

• The pooled prevalence of snakebite-associated infection was 27.0%, with significant regional variation (Asia: 32%, Americas: 21%).
• Gram-negative bacteria (63%) were the predominant pathogens, with Morganella morganii (32%) being the most frequently isolated, followed by Gram-positive cocci (40%) including Enterococcus spp. and Staphylococcus aureus.
• A high proportion of snakebite infections (68%) required surgical intervention.

Conclusions:

• Snakebite infections are highly prevalent, with M. morganii being a primary causative agent, impacting empirical treatment strategies.
• Rational antimicrobial use, guided by local pathogen prevalence and susceptibility, is crucial for managing snakebite infections.
• Prompt isolation and identification of bacteria from snakebite wounds are recommended to confirm infections and guide appropriate therapy.