Cat bite injuries to the hand and forearm: the impact of antibiotic treatment on microbiological findings and clinical outcome

Sebastian Wangler; Miriam Elias; Linus Schoepke; Dominique N Merky; Rahel Meier; Esther Vögelin

doi:10.1007/s00402-024-05277-7

Cat bite injuries to the hand and forearm: the impact of antibiotic treatment on microbiological findings and clinical outcome

Arch Orthop Trauma Surg. 2024 Mar 28. doi: 10.1007/s00402-024-05277-7. Online ahead of print.

Authors

Sebastian Wangler^{1

2}, Miriam Elias³, Linus Schoepke³, Dominique N Merky³, Rahel Meier⁴, Esther Vögelin³

Affiliations

¹ Department of Plastic and Hand Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. sebastian.wangler@insel.ch.
² Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. sebastian.wangler@insel.ch.
³ Department of Plastic and Hand Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
⁴ Berner Handzentrum, Bern, Switzerland.

PMID: 38546860
DOI: 10.1007/s00402-024-05277-7

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.

Keywords: Animal bite injuries; Bite injuries; Cat bite; Hand.