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Ten years of treating necrotizing fasciitis.

Nordqvist, Gunnar; Walldén, Axel; Brorson, Håkan LU and Tham, Johan LU (2015) In Infectious Diseases 47(5). p.319-325
Abstract
Background: Necrotizing fasciitis is a soft tissue infection characterized by rapid progression and a high mortality rate. The objective of this study was to investigate diagnosis, causative microbial agents, comorbidities, antibiotic regimen and outcome regarding this disease at Skåne University Hospital in Malmö, Sweden. Methods: From medical records, we identified 33 patients treated from January 2003 to January 2013, 31 of whom could be included in our investigation. Results: The infections were monomicrobial in 87% of the cases, and most were caused by group A streptococci. The rate of polymicrobial infections was lower than in other studies. In addition to blood and wound cultures, a rapid antigen detection test for group A... (More)
Background: Necrotizing fasciitis is a soft tissue infection characterized by rapid progression and a high mortality rate. The objective of this study was to investigate diagnosis, causative microbial agents, comorbidities, antibiotic regimen and outcome regarding this disease at Skåne University Hospital in Malmö, Sweden. Methods: From medical records, we identified 33 patients treated from January 2003 to January 2013, 31 of whom could be included in our investigation. Results: The infections were monomicrobial in 87% of the cases, and most were caused by group A streptococci. The rate of polymicrobial infections was lower than in other studies. In addition to blood and wound cultures, a rapid antigen detection test for group A streptococci was used in a majority of the cases as a supplement to other diagnostic tools. The time from onset of symptoms to surgery proved to be significantly shorter for patients infected with group A streptococci than for other patients. The mortality rate among all patients was 19%, which is lower than much of the historical material but in line with some more recent studies of this disease. Conclusions: Our results indicate that low mortality rates can be achieved by surgery, appropriate antibiotics and good supportive care. Furthermore, we show that the use of the rapid antigen detection test for group A streptococci, in this setting, helps to shorten the time to surgical intervention in patients suffering from necrotizing fasciitis. This also helps to guide the antibiotic treatment into a narrower spectrum. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Infectious Diseases
volume
47
issue
5
pages
319 - 325
publisher
Taylor & Francis
external identifiers
  • pmid:25715941
  • wos:000354612900007
  • scopus:84962536444
ISSN
2374-4243
DOI
10.3109/00365548.2014.993420
language
English
LU publication?
yes
id
4453d8f9-e1a5-4761-a4ce-2c1ac0a16eb4 (old id 5142692)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/25715941?dopt=Abstract
date added to LUP
2015-03-10 22:19:22
date last changed
2016-10-20 10:59:16
@article{4453d8f9-e1a5-4761-a4ce-2c1ac0a16eb4,
  abstract     = {Background: Necrotizing fasciitis is a soft tissue infection characterized by rapid progression and a high mortality rate. The objective of this study was to investigate diagnosis, causative microbial agents, comorbidities, antibiotic regimen and outcome regarding this disease at Skåne University Hospital in Malmö, Sweden. Methods: From medical records, we identified 33 patients treated from January 2003 to January 2013, 31 of whom could be included in our investigation. Results: The infections were monomicrobial in 87% of the cases, and most were caused by group A streptococci. The rate of polymicrobial infections was lower than in other studies. In addition to blood and wound cultures, a rapid antigen detection test for group A streptococci was used in a majority of the cases as a supplement to other diagnostic tools. The time from onset of symptoms to surgery proved to be significantly shorter for patients infected with group A streptococci than for other patients. The mortality rate among all patients was 19%, which is lower than much of the historical material but in line with some more recent studies of this disease. Conclusions: Our results indicate that low mortality rates can be achieved by surgery, appropriate antibiotics and good supportive care. Furthermore, we show that the use of the rapid antigen detection test for group A streptococci, in this setting, helps to shorten the time to surgical intervention in patients suffering from necrotizing fasciitis. This also helps to guide the antibiotic treatment into a narrower spectrum.},
  author       = {Nordqvist, Gunnar and Walldén, Axel and Brorson, Håkan and Tham, Johan},
  issn         = {2374-4243},
  language     = {eng},
  number       = {5},
  pages        = {319--325},
  publisher    = {Taylor & Francis},
  series       = {Infectious Diseases},
  title        = {Ten years of treating necrotizing fasciitis.},
  url          = {http://dx.doi.org/10.3109/00365548.2014.993420},
  volume       = {47},
  year         = {2015},
}