Department of Emergency Medicine, Chang Gung Memorial Hospital, No,6, W, Sec,, Jiapu Rd,, Puzih City, Chiayi County 613, Taiwan.
Crit Care. 2011 Jun 21;15(3):R152. doi: 10.1186/cc10278.
Necrotizing fasciitis (NF) is a life threatening infectious disease with a high mortality rate. We carried out a microbiological characterization of the causative pathogens. We investigated the correlation of mortality in NF with bloodstream infection and with the presence of co-morbidities.
In this retrospective study, we analyzed 323 patients who presented with necrotizing fasciitis at two different institutions. Bloodstream infection (BSI) was defined as a positive blood culture result. The patients were categorized as survivors and non-survivors. Eleven clinically important variables which were statistically significant by univariate analysis were selected for multivariate regression analysis and a stepwise logistic regression model was developed to determine the association between BSI and mortality.
Univariate logistic regression analysis showed that patients with hypotension, heart disease, liver disease, presence of Vibrio spp. in wound cultures, presence of fungus in wound cultures, and presence of Streptococcus group A, Aeromonas spp. or Vibrio spp. in blood cultures, had a significantly higher risk of in-hospital mortality. Our multivariate logistic regression analysis showed a higher risk of mortality in patients with pre-existing conditions like hypotension, heart disease, and liver disease. Multivariate logistic regression analysis also showed that presence of Vibrio spp in wound cultures, and presence of Streptococcus Group A in blood cultures were associated with a high risk of mortality while debridement > = 3 was associated with improved survival.
Mortality in patients with necrotizing fasciitis was significantly associated with the presence of Vibrio in wound cultures and Streptococcus group A in blood cultures.
坏死性筋膜炎（NF）是一种具有高死亡率的危及生命的感染性疾病。我们对致病病原体进行了微生物学特征分析。我们调查了 NF 患者的死亡率与血流感染和合并症之间的相关性。
在这项回顾性研究中，我们分析了在两家不同机构就诊的 323 例坏死性筋膜炎患者。血流感染（BSI）定义为阳性血培养结果。患者分为存活组和非存活组。通过单因素分析选择了 11 个具有统计学意义的临床重要变量进行多变量回归分析，并建立逐步逻辑回归模型以确定 BSI 与死亡率之间的关系。
单因素逻辑回归分析表明，存在低血压、心脏病、肝病、伤口培养物中存在弧菌属、伤口培养物中存在真菌、以及血液培养物中存在 A 群链球菌、气单胞菌属或弧菌属的患者，院内死亡率显著升高。我们的多变量逻辑回归分析显示，存在低血压、心脏病和肝病等基础疾病的患者死亡风险更高。多变量逻辑回归分析还表明，伤口培养物中存在弧菌属和血液培养物中存在 A 群链球菌与高死亡率相关，而清创术> = 3 与生存改善相关。
坏死性筋膜炎患者的死亡率与伤口培养物中存在弧菌属和血液培养物中存在 A 群链球菌属显著相关。
