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Bacteriology of necrotizing fasciitis: a review of 58 cases
Abstract:
Necrotizing fasciitis is a relatively rare soft tissue infection that is characterized by rapidly widespread necrosis of the fascia and subcutaneous tissue. Fifty-eight cases were reviewed over a 5.5-year period. The majority of wound cultures were polymicrobial and single culture rate was 18.6%. The facultative organisms were most frequently recovered. The most frequently discovered bacteria were E. coli, Proteus mirabilis, Klebsiella pneumoniae, Staphylococcus aureus and group D enterococcus. The overall mortality rate was 48.3%. Early recognition, serial radical surgical debridement and strong and appropriate antibiotics were essential for survival.
Insights
Necrotizing fasciitis, a severe soft tissue infection, often involves multiple bacteria. Prompt surgical intervention and antibiotics are crucial for survival in patients with this aggressive condition.
Area of Science:
- Infectious Diseases
- Surgical Pathology
Background:
- Necrotizing fasciitis is a rare but severe soft tissue infection.
- It is characterized by rapid, widespread necrosis of fascia and subcutaneous tissue.
Purpose of the Study:
- To review cases of necrotizing fasciitis to identify common pathogens and outcomes.
- To determine factors essential for patient survival.
Main Methods:
- Retrospective review of 58 necrotizing fasciitis cases over 5.5 years.
- Analysis of wound cultures for microbial identification.
- Evaluation of treatment strategies and patient mortality.
Main Results:
- The majority of wound cultures were polymicrobial (81.4%).
- Commonly identified bacteria included E. coli, Proteus mirabilis, Klebsiella pneumoniae, Staphylococcus aureus, and group D enterococcus.
- The overall mortality rate was high at 48.3%.
Conclusions:
- Early recognition and aggressive surgical debridement are critical.
- Appropriate antibiotic therapy is essential for improving survival rates.
- Polymicrobial infections are frequent in necrotizing fasciitis.