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Necrotising fasciitis--an old enemy or a new foe

Y H Li1, C L Toh, C Khoo

  • 1Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore.

Annals of the Academy of Medicine, Singapore
|March 1, 1997
PubMed

Insights

Necrotising fasciitis, a severe infection, is increasingly caused by multiple bacteria, not just Streptococcus. This study found polymicrobial infections and antimicrobial resistance in 19 cases, with a significant mortality rate.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Surgery

Background:

  • Meleney's original description of necrotising fasciitis primarily implicated Streptococcus pyogenes.
  • Subsequent reports confirmed Streptococcus as the predominant pathogen.
  • Recent observations suggest a shift towards other causative organisms.

Purpose of the Study:

  • To analyze recent cases of necrotising fasciitis to determine if the disease entity has changed.
  • To investigate the spectrum of causative organisms and patient demographics.
  • To assess treatment resistance and outcomes in contemporary necrotising fasciitis cases.

Main Methods:

  • Retrospective analysis of 19 necrotising fasciitis cases managed in Orthopaedic Surgery.
  • Data collected over a 24-month period.
  • Evaluation of patient demographics, comorbidities, causative agents, treatment, and mortality.

Main Results:

  • The study included 19 patients aged 19-85 years (average 57.2).
  • Males were predominantly affected (16/19).
  • A high proportion of patients had underlying diseases (16/19).
  • A trend towards polymicrobial infections was observed.
  • Many infections showed resistance to standard antimicrobial therapy.
  • The overall mortality rate was 21.1%.

Conclusions:

  • Necrotising fasciitis may be evolving, with a notable increase in polymicrobial infections.
  • Antimicrobial resistance is a significant concern in managing this condition.
  • The findings highlight the need for updated diagnostic and therapeutic strategies for necrotising fasciitis.

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