{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T21:57:03Z","timestamp":1791928623835,"version":"4.3.4"},"reference-count":96,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","license":[{"start":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T00:00:00Z","timestamp":1714521600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,1]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Snakebites still constitute a significant public health problem in developing countries and are considered a neglected tropical condition by the WHO. Snake accidents are associated with substantial morbidity and mortality and may produce secondary complications, such as severe infections. The objective of this systematic review was to determine the prevalence of snakebite infections and characterize the bacteria isolated from these infections. A systematic literature review in five databases was carried out to assess the prevalence of snakebite infection. A meta-analysis was performed using a random-effects model to calculate the pooled prevalence and 95% CIs. Cochran\u2019s <jats:italic>Q<\/jats:italic> test and the <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> statistic were used to assess between-study heterogeneity. The pooled prevalence of infection due to snakebite was 27.0% (95% CI: 22.0\u201332.0%), with high heterogeneity among studies (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 99.7%). The prevalence was higher in Asia (32%) than in the Americas (21%). Snakebite infections required surgical interventions in 68% (95% CI: 37.0\u201398.0%). The leading group of pathogens identified corresponded to Gram-negative bacteria (63%), particularly <jats:italic>Morganella morganii<\/jats:italic> (32%), but also, Gram-positive cocci (40%), especially <jats:italic>Enterococcus<\/jats:italic> spp. (23%) and <jats:italic>Staphylococcus aureus<\/jats:italic> (15%). However, multiple other pathogens, including anaerobes, were found. A high prevalence of snakebite-associated infection has been described, primarily due to <jats:italic>M. morganii<\/jats:italic>, with the corresponding implications for empirical therapy. Rational use of antimicrobials is recommended, and this should guide initial empirical treatment. Moreover, isolation and identification of the possible bacteria present in snakebite wounds is recommended in all cases to confirm or rule out associated infection.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0278","type":"journal-article","created":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T15:14:04Z","timestamp":1714576444000},"page":"874-886","source":"Crossref","is-referenced-by-count":30,"title":["Snakebite-Associated Infections: A Systematic Review and Meta-Analysis"],"prefix":"10.4269","volume":"110","author":[{"given":"D. Katterine","family":"Bonilla-Aldana","sequence":"first","affiliation":[{"name":"Research Unit, Universidad Continental, Huancayo, Peru;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge Luis","family":"Bonilla-Aldana","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Ciencias Animales Macagual, Universidad de La Amazonia, Florencia, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan R.","family":"Ulloque-Badaracco","sequence":"additional","affiliation":[{"name":"Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Al-kassab-C\u00f3rdova","sequence":"additional","affiliation":[{"name":"Centro de Excelencia en Investigaciones Econ\u00f3micas y Sociales en Salud, Universidad San Ignacio de Loyola, Lima, Peru;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique A.","family":"Hernandez-Bustamante","sequence":"additional","affiliation":[{"name":"Grupo Peruano de Investigaci\u00f3n Epidemiol\u00f3gica, Unidad para la Generaci\u00f3n y S\u00edntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Per\u00fa;"},{"name":"Sociedad Cient\u00edfica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, Peru;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esteban A.","family":"Alarcon-Braga","sequence":"additional","affiliation":[{"name":"Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdelmonem","family":"Siddiq","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, Mansoura University, Mansoura, Egypt;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicente A.","family":"Benites-Zapata","sequence":"additional","affiliation":[{"name":"Unidad de Investigaci\u00f3n para la Generaci\u00f3n y S\u00edntesis de Evidencias en Salud, Vicerrectorado de Investigaci\u00f3n, Universidad San Ignacio de Loyola, Lima, Peru;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfonso J.","family":"Rodriguez-Morales","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n Biomedicina, Faculty of Medicine, Fundaci\u00f3n Universitaria Aut\u00f3noma de las Am\u00e9ricas-Instituci\u00f3n Universitaria Visi\u00f3n de las Am\u00e9ricas, Pereira, Colombia;"},{"name":"Faculty of Health Sciences, Universidad Cient\u00edfica del Sur, Lima, Peru;"},{"name":"Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila","family":"Luna","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Universidad Cient\u00edfica del Sur, Lima, Peru;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose 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