University Centre for Plastic, Aesthetic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany.
Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany.
Clin Hemorheol Microcirc. 2024;86(1-2):169-181. doi: 10.3233/CH-238119.
Necrotizing fasciitis (NF) is a rare but life-threatening condition in which extensive soft tissue destruction can occur very quickly if left untreated. Therefore, timely broad-spectrum antibiotic administration is of prognostic importance in addition to radical surgical debridement.
This study evaluates the cases of NF in our hospital during the last ten years retrospectively with respect to the pathogens involved and their antimicrobial resistance. This approach aims to provide guidance regarding the most targeted initial antibiotic therapy.
We performed a retrospective microbiological study evaluating pathogen detection and resistance patterns including susceptibility testing of 42 patients with NF.
Type 1 NF (polymicrobial infection) occurred in 45% of the patients; 31% presented type 2 NF (monomicrobial infection). The most common pathogens detected were E. coli, staphylococci such as Staphylococcus aureus and Staphylococcus epidermidis, Proteus mirabilis, enterococci, and streptococci such as Streptococcus pyogenes. Twelve percent presented an additional fungus infection (type 4). Ten percent showed no cultivation. Two percent (one patient) presented cocci without specification.
Most pathogens were sensitive to antibiotics recommended by guidelines. This confirms the targeting accuracy of the guidelines. Further studies are necessary to identify risk factors associated with multidrug resistant infections requiring early vancomycin/meropenem administration.
坏死性筋膜炎（NF）是一种罕见但危及生命的疾病，如果不及时治疗，广泛的软组织破坏可能会迅速发生。因此，除了彻底的外科清创术外，及时给予广谱抗生素治疗对于预后具有重要意义。
本研究回顾性评估了过去十年我院收治的 NF 病例，涉及相关病原体及其耐药性。这一方法旨在为初始靶向抗生素治疗提供指导。
我们进行了一项回顾性微生物学研究，评估了 42 例 NF 患者的病原体检测和耐药模式，包括药敏试验。
1 型 NF（混合感染）占 45%；31%为 2 型 NF（单一感染）。最常见的病原体包括大肠杆菌、金黄色葡萄球菌和表皮葡萄球菌、奇异变形杆菌、肠球菌和化脓性链球菌。12%的患者合并真菌感染（4 型）。10%的患者未培养出病原体。2%（1 例）的患者为未分类的球菌。
大多数病原体对指南推荐的抗生素敏感。这证实了指南的靶向准确性。需要进一步研究以确定与需要早期使用万古霉素/美罗培南治疗的多重耐药感染相关的危险因素。
