Comparison of Surgical Outcomes and Predictors in Patients with Monomicrobial Necrotizing Fasciitis and Sepsis Caused by , , and .

Monomicrobial necrotizing fasciitis caused by , , and are often associated with high mortality rates. The purpose of this study was to compare the independent predictors related to outcomes between and species necrotizing fasciitis. Monomicrobial necrotizing fasciitis caused by (60 patients) and species (31 patients) over an 11-year period were reviewed retrospectively. Differences in mortality, patient characteristics, clinical presentations, and laboratory data were compared between the and species groups, and between the death and the survival subgroups of patients with species. Six patients in the group (10%) and 11 in the species group (32.3%) died. Fifty-nine patents had bacteremia and 16 patients died (27.1%). Patients who had had a higher incidence of bacteremia. The patients who had species presenting with bacteremia were significantly associated with death. The death subgroup of patients with necrotizing fasciitis had a higher incidence of bacteremia, higher counts of banded leukocytes, lower platelet counts, lower total lymphocyte counts, and lower serum albumin level than the survival subgroup. Monomicrobial necrotizing fasciitis caused by species was characterized by more fulminating and higher mortality than that of , even after early fasciotomy and third-generation cephalosporin antibiotic therapy. Those risk factors, such as bacteremia, shock, lower platelet counts, lower albumin levels, and antibiotic resistance were associated with mortality, which should alert clinicians to pay more attention to and aggressively treat those patients with and necrotizing fasciitis.