Infections following stingray attacks: A case series and literature review of antimicrobial resistance and treatment. Issue 47 (May 2022)

• Record Type: Journal Article
• Authors: Cevik, Jevan; Hunter-Smith, David J.; Rozen, Warren M.
• Is Part Of: Travel medicine and infectious disease. Issue 47(2022)
• Publication Date: 2022-05
• Subjects: Marine trauma -- Soft tissue infection -- Antibiotic resistance -- Antibiotic treatment; Travel -- Health aspects -- Periodicals; Communicable diseases -- Periodicals; Tropical medicine -- Periodicals; 610.5
• DOI: 10.1016/j.tmaid.2022.102312
• Languages: English
• ISSNs: 1477-8939

Abstract

Abstract: Background: Injuries sustained following stingray attacks are at high risk of infection and can progress to serious, debilitating consequences for the patient if not appropriately addressed. Antibiotic treatment of such infections is important to minimise the morbidity experienced by patients. However, antibiotic guidelines relating specific to this patient group are not well established. This study aims to report the experience of a single institution at treating stingray associated wound infections and to review the literature for reported cases. Additionally, we review the microbiological risk in these patients and summarise the literature surrounding antibiotic choice. Methods: A retrospective review of all patients presenting with injuries sustained following stingray attacks was conducted at a single institution. Additionally, a comprehensive literature review was conducted to identify cases of infected stingray associated trauma and review the causative micro-organisms and antibiotics used to treat such infections. Results: 22 cases of stingray injuries were identified from a single institution. Of these, eight infections were reported. One case grew a highly resistant Vibrio species. Among the literature, 18 cases of infections were identified many of which led to significant complications for patients. The micro-organisms identified were diverse and there was little consistency among the antibiotic regimens utilised. Conclusion: Based on the antibiotic susceptibilities of causative bacteria along with extrapolation from recommendations and guidelines identified in the literature, ciprofloxacin, doxycycline and trimethoprim-sulfamethoxazole appear to be the most appropriate antibiotics choices for prophylaxis or treatment of localised infection. Antibiotic choices for the empiric treatment of systemic infection requires further research and clarification.