Microorganisms and Antibiogram Patterns in Fournier's Gangrene: Contemporary Experience from a Single Tertiary Care Center.

Autor:	Castillejo Becerra CM; Ohio State University Wexner Medical Center, Department of Urology, Columbus, Ohio., Jaeger CD; Ohio State University Wexner Medical Center, Department of Urology, Columbus, Ohio., Rose JR; Ohio State University Wexner Medical Center, Department of Urology, Columbus, Ohio., Beecroft NJ; Ohio State University Wexner Medical Center, Department of Urology, Columbus, Ohio., Shah NC; Ohio State University Wexner Medical Center, Department of Urology, Columbus, Ohio., Posid T; Ohio State University Wexner Medical Center, Department of Urology, Columbus, Ohio., Jenkins LC; Ohio State University Wexner Medical Center, Department of Urology, Columbus, Ohio., Baradaran N; Ohio State University Wexner Medical Center, Department of Urology, Columbus, Ohio.
Jazyk:	angličtina
Zdroj:	The Journal of urology [J Urol] 2020 Dec; Vol. 204 (6), pp. 1249-1255. Date of Electronic Publication: 2020 Jun 30.
DOI:	10.1097/JU.0000000000001194
Abstrakt:	Purpose: We evaluate the prevalent microorganisms, antibiotic sensitivity patterns and associated outcomes in patients with Fournier's gangrene. Materials and Methods: A retrospective chart review of patients with Fournier's gangrene was conducted between October 2011 and April 2018 at our institution. Univariate analysis was performed using the independent t-test or Kruskal-Wallis H test for continuous variables and exact test for categorical variables. Results: Of the 143 patients included in this study, wound culture was available in 131 (92%) patients with a median number of 3 microorganisms per wound. The most commonly grown pathogens were Staphylococcus species (66, 46%), Streptococcus species (53, 37%), Bacteroides species (34, 24%), Candida species (31, 22%), Escherichia coli (28, 20%) and Prevotella species (26, 18%). Most bacteria were sensitive to ampicillin-sulbactam, ceftriaxone, piperacillin-tazobactam, amikacin and cefepime, and resistant to ampicillin, trimethoprim-sulfamethoxazole, levofloxacin and clindamycin. Enterococcus faecalis and Streptococcus anginosus were resistant to vancomycin. The overall Fournier's gangrene mortality count was 14 (10%) patients. No association was noted between the type of infection and Fournier's gangrene severity index, length of hospital stay or mortality. Conclusions: At our institution Candida is a prevalent pathogen in the wound culture of patients with Fournier's gangrene. The resistance patterns for clindamycin and vancomycin are concerning. Addition of an antifungal agent to the empiric treatment should be considered based on clinical presentation.
Databáze:	MEDLINE
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