Abstract

Naja atra is a major venomous snake found in Taiwan. The bite of this snake causes extensive wound necrosis or necrotizing soft tissue infection. Conventional microbial culture-based techniques may fail to identify potential human pathogens and render antibiotics ineffective in the management of wound infection. Therefore, we evaluated 16S Sanger sequencing and next-generation sequencing (NGS) to identify bacterial species in the oropharynx of N. atra. Using conventional microbial culture methods and the VITEK 2 system, we isolated nine species from snakebite wounds. On the basis of the 16S Sanger sequencing of bacterial clones from agar plates, we identified 18 bacterial species in the oropharynx of N. atra, including Morganella morganii, Proteus vulgaris, and Proteus mirabilis, which were also present in the infected bite wound. Using NGS of 16S metagenomics, we uncovered more than 286 bacterial species in the oropharynx of N. atra. In addition, the bacterial species identified using 16S Sanger sequencing accounted for only 2% of those identified through NGS of 16S metagenomics. The bacterial microbiota of the oropharynx of N. atra were modeled better using NGS of 16S metagenomics compared to microbial culture-based techniques. Stenotrophomonas maltophilia, Acinetobacter baumannii, and Proteus penneri were also identified in the NGS of 16S metagenomics. Understanding the bacterial microbiota that are native to the oropharynx of N. atra, in addition to the bite wound, may have additional therapeutic implications regarding empiric antibiotic selection for managing N. atra bites.

Highlights

  • Snakebites are one of the most neglected tropical diseases [1, 2]

  • Only 9 species were detected in cobra bites using a conventional microbial culture method and the VITEK 2 system, whereas 18 species were detected in the cobra oropharynx using microbial culture-based 16S Sanger sequencing

  • Morganella morganii, Proteus vulgaris, and Proteus mirabilis were identified as common bacteria

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Summary

Introduction

Snakebites are one of the most neglected tropical diseases [1, 2]. Worldwide, more than five million people are bitten and up to 2.7 million are envenomed every year [1]. N. atra is the only Naja species distributed in Taiwan. This snake accounts for only 6% of all snake bite incidents but causes the most severe infectious complications among the major venomous snakes [7, 8]. Using conventional culturing techniques [11], Enterococcus spp. and Morganella morganii were the most commonly isolated pathogens in infected N. atra bite wounds, which is similar to the snake’s oral cavity [5, 7, 12, 13]. The high surgical proportion may be due to the poor efficacy of the antivenom against the cytotoxic components of the venom, failure of conventional culture-based techniques to report less significant or nonculturable microorganisms, including potential human pathogens, or improperly chosen empiric antibiotics [14,15,16]

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