Wound Infections Following Snake-Related Injuries in Malaysia: A Retrospective Analysis of Remote Envenomation Consultancy Services Data.

Snake-related injuries (SRI) in Malaysia are a medical emergency. SRI may be accompanied by wound infection requiring medical and surgical intervention. Despite its clinical relevance, local epidemiological and microbiological data remain limited in Malaysia. This was an observational analysis conducted on 72 hospitalised patients with wound infections following snake-related injuries who received consultation from the Remote Envenomation Consultancy Services (RECS). Data were collected using a standardised collection form. Among 559 hospitalised SRI cases, 72 patients (12.9%) developed wound infections. Males accounted for 70.8%, and most patients with wound infections were young adults aged 18 to 44. The most frequent symptoms were swelling (91.7%) and erythema (69.4%). SRI from Naja species were the most frequently identified cause of wound infections. Bacterial cultures were positive in 15.3% of cases, with Enterococcus species being the most frequently identified. Amoxicillin/clavulanate was the most used antibiotic. Wound debridement was performed in 27.8% of cases. Most patients were hospitalised for more than 5 days, and the most common outcome was healed with a scar (34.7%). No mortality was reported. This study emphasises the need for accurate clinical assessments to distinguish between venom-induced inflammation and subsequent bacterial infection. Although the culture-positive rate was low, the presence of pathogens such as Enterococcus species, which are often resistant to standard antibiotics, emphasises the need for cultures and sensitivity testing in snakebite-related infections. Early antivenom therapy, adequate antibiotic usage, and prompt surgical intervention, such as debridement, will improve patient outcomes. These findings provide useful local insights for clinical guidelines and for better management of wound infections following snake-related injuries in Malaysia.