Monomicrobial necrotizing fasciitis in a single center: the emergence of Gram-negative bacteria as a common pathogen
| Autor: | D. Yahav, H. Duskin-Bitan, N. Eliakim-Raz, H. Ben-Zvi, H. Shaked, E. Goldberg, J. Bishara |
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| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: | |
| Zdroj: | International Journal of Infectious Diseases, Vol 28, Iss C, Pp 13-16 (2014) |
| Druh dokumentu: | article |
| ISSN: | 1201-9712 1878-3511 |
| DOI: | 10.1016/j.ijid.2014.05.024 |
| Popis: | Background: Necrotizing fasciitis (NF) is a life-threatening soft tissue infection. It is usually caused by Streptococcus pyogenes and other Gram-positive bacteria. Several reports, however, emphasize the importance of Gram-negative rods in this infection. Methods: We retrospectively studied all cases of monomicrobial necrotizing fasciitis hospitalized in our center during the years 2002–2012. We compared clinical characteristics and outcomes of patients with Gram-negative versus Gram-positive infection. Results: Forty-five cases were reviewed, 19 caused by Gram-negative organisms, 10 of them Escherichia coli, and 26 caused by Gram-positive organisms, 10 of them S. pyogenes. Compared to Gram-positive infections, patients with Gram-negative infections were more likely to have a baseline malignancy (9/19, 47.4%) or to have undergone recent surgery (4/19, 42.3%). The 30-day mortality was higher among Gram-negative infected patients (8/19, 42.1% vs. 8/26, 30.8%). Creatine phosphokinase (CPK) was elevated in a minority of patients with Gram-negative necrotizing fasciitis, and its absolute value was lower than in Gram-positive necrotizing fasciitis. Conclusions: In our center, 42% of monomicrobial necrotizing fasciitis cases were found to be caused by Gram-negative organisms, mostly E. coli. These infections usually appeared in immunocompromised or postoperative patients, often presented with normal CPK levels, and were associated with high mortality rates. |
| Databáze: | Directory of Open Access Journals |
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