Monomicrobial necrotizing fasciitis in a single center: the emergence of Gram-negative bacteria as a common pathogen
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 cas...
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| Format: | Article |
| Language: | English |
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Elsevier
2014-11-01
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| Series: | International Journal of Infectious Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971214015525 |
| _version_ | 1818750763360321536 |
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| author | D. Yahav H. Duskin-Bitan N. Eliakim-Raz H. Ben-Zvi H. Shaked E. Goldberg J. Bishara |
| author_facet | D. Yahav H. Duskin-Bitan N. Eliakim-Raz H. Ben-Zvi H. Shaked E. Goldberg J. Bishara |
| author_sort | D. Yahav |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-18T04:24:50Z |
| format | Article |
| id | doaj.art-3c71839d54124d1699543385c0511465 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 1878-3511 |
| language | English |
| last_indexed | 2024-12-18T04:24:50Z |
| publishDate | 2014-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-3c71839d54124d1699543385c05114652022-12-21T21:21:09ZengElsevierInternational Journal of Infectious Diseases1201-97121878-35112014-11-0128C131610.1016/j.ijid.2014.05.024Monomicrobial necrotizing fasciitis in a single center: the emergence of Gram-negative bacteria as a common pathogenD. Yahav0H. Duskin-Bitan1N. Eliakim-Raz2H. Ben-Zvi3H. Shaked4E. Goldberg5J. Bishara6Infectious Diseases Unit, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, IsraelDepartment of Medicine F-Recanati, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, IsraelInfectious Diseases Unit, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, IsraelDepartment of Clinical Microbiology, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, IsraelInfectious Diseases Unit, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, IsraelInfectious Diseases Unit, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, IsraelInfectious Diseases Unit, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, IsraelBackground: 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.http://www.sciencedirect.com/science/article/pii/S1201971214015525Necrotizing fasciitisEscherichia coliGram-negativeSoft tissue infectionCreatine phosphokinase |
| spellingShingle | D. Yahav H. Duskin-Bitan N. Eliakim-Raz H. Ben-Zvi H. Shaked E. Goldberg J. Bishara Monomicrobial necrotizing fasciitis in a single center: the emergence of Gram-negative bacteria as a common pathogen International Journal of Infectious Diseases Necrotizing fasciitis Escherichia coli Gram-negative Soft tissue infection Creatine phosphokinase |
| title | Monomicrobial necrotizing fasciitis in a single center: the emergence of Gram-negative bacteria as a common pathogen |
| title_full | Monomicrobial necrotizing fasciitis in a single center: the emergence of Gram-negative bacteria as a common pathogen |
| title_fullStr | Monomicrobial necrotizing fasciitis in a single center: the emergence of Gram-negative bacteria as a common pathogen |
| title_full_unstemmed | Monomicrobial necrotizing fasciitis in a single center: the emergence of Gram-negative bacteria as a common pathogen |
| title_short | Monomicrobial necrotizing fasciitis in a single center: the emergence of Gram-negative bacteria as a common pathogen |
| title_sort | monomicrobial necrotizing fasciitis in a single center the emergence of gram negative bacteria as a common pathogen |
| topic | Necrotizing fasciitis Escherichia coli Gram-negative Soft tissue infection Creatine phosphokinase |
| url | http://www.sciencedirect.com/science/article/pii/S1201971214015525 |
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