Clinical Profile and Outcomes of Patients With Necrotizing Soft Tissue Infections: A Prospective Observational Study

Area of Science:

• Infectious Diseases
• Surgical Infections
• Critical Care Medicine

Background:

• Necrotising soft tissue infection (NSTI) presents complex management challenges.
• Diverse clinical signs, comorbidities, and microbial causes complicate NSTI treatment.
• Understanding NSTI's clinical profile and mortality factors is crucial.

Purpose of the Study:

• To analyze the clinical characteristics of NSTI patients.
• To identify microbiological patterns in NSTI.
• To determine factors influencing mortality in NSTI cases.

Main Methods:

• Prospective observational study at a single center.
• Included 87 adult patients diagnosed with NSTI.
• Primary outcome: time to surgery's impact on mortality; secondary: etiology, flora, comorbidities, outcomes.

Main Results:

• 87 patients (74.7% male, 18-88 years) enrolled; 18 deaths (20.7%).
• Average time to intervention was 6 hours, with no significant difference between survivors and non-survivors.
• Escherichia coli was the most common isolate; increased resistance to cephalosporins and fluoroquinolones observed.

Conclusions:

• High APACHE II and LRINEC scores, anemia, hypoalbuminemia, and high creatinine are mortality predictors.
• Prompt, multidisciplinary management is key to improving NSTI patient outcomes.
• Early surgical intervention timing did not significantly impact mortality in this cohort.