1UMR 1094 Neuroépidémiologie Tropicale, University of Limoges, Limoges, France.
2Cardio-Surgical Intensive Care Unit, CHU Limoges, Limoges, France.
Am J Trop Med Hyg. 2021 Jul 19;105(3):596-599. doi: 10.4269/ajtmh.21-0009.
This retrospective and single-center study in Reunion Island (Indian Ocean) assessed frequency, mortality, causative pathogens of severe necrotizing skin, and necrotizing skin and soft tissue infections (NSSTIs) admitted in intensive care unit (ICU). Sixty-seven consecutive patients were included from January 2012 to December 2018. Necrotizing skin and soft tissue infection represented 1.06% of total ICU admissions. We estimate the incidence of NSSTI requiring ICU at 1.21/100,000 person/years in Reunion Island. Twenty (30%) patients were receiving nonsteroidal anti-inflammatory drugs (NSAIDs) prior to admission in ICU and 40 (60%) were diagnosed patients with diabetes. Sites of infection were the lower limb in 52 (78%) patients, upper limb in 4 (6%), and perineum in 10 (15%). The surgical treatment was debridement for 40 patients, whereas 11 patients required an amputation. The most commonly isolated microorganisms were Streptococci (42%) and Gram-negative bacteria (22%).The mortality rate was 25.4%. NSAIDs did not influence mortality when interrupted upon admission to ICU.
这项在印度洋留尼汪岛进行的回顾性单中心研究评估了重症坏死性皮肤和坏死性皮肤和软组织感染（NSSTIs）在重症监护病房（ICU）住院的频率、死亡率、病原体。从 2012 年 1 月至 2018 年 12 月，连续纳入了 67 名患者。坏死性皮肤和软组织感染占 ICU 总入院人数的 1.06%。我们估计留尼汪岛需要 ICU 治疗的 NSSTI 发病率为 1.21/100,000 人/年。20 名（30%）患者在入住 ICU 前正在服用非甾体抗炎药（NSAIDs），40 名（60%）患者被诊断为糖尿病患者。感染部位为下肢 52 例（78%）、上肢 4 例（6%）、会阴 10 例（15%）。40 名患者接受了清创术，11 名患者需要截肢。最常见的分离微生物是链球菌（42%）和革兰氏阴性菌（22%）。死亡率为 25.4%。入院时中断 NSAIDs 治疗并未影响死亡率。
